Fatal hemorrhage in stented esophageal carcinoma: tumor necrosis of the aorta.
We report a case of fatal hematemesis in a patient with an esophageal stent for palliation of malignant dysphagia. Post-mortem examination showed tumor thrombi in the vasa vasorum of the aorta causing aortic wall necrosis and perforation. Massive delayed hemorrhage is reported as a complication of metallic esophageal endoprostheses but in the majority of cases there have been no post-mortem examinations. In this case the post-mortem examination demonstrated that the cause of death was not stent-related. We feel that this case report adds important information to the current literature regarding the delayed complications seen in patients with esophageal carcinoma who have been palliated with metallic stents.
Kennedy
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Department of Radiology, University Hospital Lewisham, London, UK.
Steger
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D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002277:Carcinoma / Q000401:mortality* / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009336:Necrosis; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000401:mortality*; D015607:Stents / Q000009:adverse effects*; D017211:Treatment Failure