Aortoesophageal fistula: early postoperative complication at the distal anastomosis of an aortic graft.
Though secondary aortoesophageal fistula and subsequent hemorrhage is rare, the clinician must have a high index of suspicion to establish the correct diagnosis and institute appropriate treatment. We have proposed an algorithm to help prevent a massive hemorrhage such as the one that proved fatal in our patient. In the case of massive upper gastrointestinal hemorrhage, a Sengstaken-Blakemore tube should be done expeditiously. In the case of sentinel hemorrhage, aortography is the initial diagnostic procedure of choice, followed by flexible esophagogastroscopy if necessary.
Borrero
E
E
Department of Surgery, Georgia Baptist Medical Center, Atlanta, Ga.
Aylward
C A
CA
Logan
W D
WD
D000368:Aged; D000465:Algorithms; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001018:Aortic Diseases / Q000209:etiology*; D004937:Esophageal Fistula / Q000209:etiology* / Q000473:pathology; D005402:Fistula / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D011183:Postoperative Complications