Fistulas between the aorta and tracheobronchial tree.
Aortobronchial fistula is a rare condition that is invariably fatal if not diagnosed and surgically treated. With appropriate surgical intervention, survival rates greater than 70% can be achieved. A review of the literature and an illustrative case report are presented. A total of 63 fistulas in 62 patients have been described. The case we present is unusual in the use of serratus anterior muscle for repair of the fistula. Eighty-seven percent of the cases documented in the literature were associated with an aneurysm of the thoracic aorta. Eighty-six percent of the fistulas were between the descending aorta and left bronchopulmonary tree. More than 95% of patients experienced at least a single episode of hemoptysis, and massive hemoptysis occurred in more than half of the reported cases. A correct preoperative diagnosis was made in only 54% of cases. Plain chest radiographs definitively demonstrated an aneurysm in only 16%. The computed tomographic scan was the most rewarding test, identifying an aneurysm in 11 of 12 patients and the fistula in 50% of them. Surgical repair resulted in a 76% survival rate.
MacIntosh
E L
EL
Department of Surgery, University of Manitoba, Winnipeg, Canada.
Parrott
J C
JC
Unruh
H W
HW
D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000175:diagnosis / Q000601:surgery*; D005402:Fistula / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D014133:Tracheal Diseases / Q000175:diagnosis / Q000601:surgery*