[Upper gastrointestinal hemorrhage caused by a fistula from a right anomalous subclavian artery to the esophagus].
Bleeding from an arterio-esophageal fistula is a rare and nearly lethal condition and surgical treatment is the only curative option. We report a case of bleeding from a fistula from an aberrant right subclavian artery to the esophagus. Diagnosis was made only at necropsy, despite of three previous laparotomies. This anatomical variation is found in 0.5% of the general population. Development of a communication between this artery and the esophagus, secondary to aneurysmatic dilatation or to prolonged nasogastric intubation, as probably occurred with this patient, is a extremely rare condition. Surgical treatment depends on the early recognition of clinical signs of the arterio-esophageal communication, before the onset of systemic complications of hypovolemic shock.
Disciplina de Gastroenterologia Cirúrgica do Departamento de Cirurgiae, Universidade Federal de São Paulo, Escola Paulista de Medicina.
R
R
Colleoni Neto
A
A
Figueira
E
E
Belassai
M E
ME
Jorge Júnior
J C
JC
Del Grande
S H
SH
Cardoso
C M
CM
Haddad
D000293:Adolescent; D004937:Esophageal Fistula / Q000150:complications* / Q000601:surgery; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D013348:Subclavian Artery / Q000601:surgery; D016157:Vascular Fistula / Q000150:complications* / Q000601:surgery