Aortoesophageal fistula caused by aneurysm of the thoracic aorta: successful surgical treatment, case report, and literature review.
Aortoesophageal fistula induced by atherosclerotic thoracic aortic aneurysm is rare, but is usually a fatal disorder, with few survivors reported. We report the case of a 72-year-old man with aortoesophageal fistula successfully treated in a two-stage operation. In the first stage, we performed resection and replacement of the aortic aneurysm with a prosthetic graft in situ, esophagectomy, cervical esophagostomy, and jejunostomy. After the patient recovered well postoperatively, a transmediastinal retrosternal interposition of the stomach was performed, with esophagogastroanastomosis in the cervical area, to re-establish the gastrointestinal tract. We include a discussion of the causes, diagnostic approach, management of the aorta and esophagus, and review of the literature.
da Silva
E S
ES
Department of Surgery, São Paulo University School of Medicine, Brazil.
Tozzi
F L
FL
Otochi
J P
JP
de Tolosa
E M
EM
Neves
C R
CR
Fortes
F
F
D000368:Aged; D000714:Anastomosis, Surgical; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D016629:Esophagectomy; D004946:Esophagostomy; D006801:Humans; D007582:Jejunostomy; D008297:Male; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000601:surgery*