Thoracic aortic aneurysm with aortobronchial fistula: a thirteen-year experience.
OBJECTIVE
This study investigated the causes of aortobronchial fistula, clinical features, diagnostic modalities, and prognostic factors.


METHODS
A retrospective analysis of 17 patients with aortobronchial fistula secondary to thoracic aortic aneurysm was studied.


METHODS
Retrospective chart review was used.


RESULTS
Atherosclerosis (47.1%), infection (23.5%), and previous thoracic vascular surgery (17.6%) accounted for most causes. Most patients (94.1%) experienced at least 1 episode of hemoptysis. Chest computer tomography is the most useful tool and revealed hematoma or consolidation around the aneurysm in more than half of our patients. Bronchoscopy and aortoangiogram frequently did not demonstrate an aortobronchial fistula. The 6 patients in the surgery group all survived, in contrast to 100% mortality in the non-surgery group. The average interval between initial presentation of hemoptysis and surgical intervention in the surgery group is 68 days, in contrast to 170 days between initial presentation of hemoptysis and death in the non-surgery group.


CONCLUSIONS
A high index of suspicion will decrease delayed diagnosis. Early diagnosis and emergent surgery are 2 prognostic factors for survival.
Liu
Shih-Feng
SF
Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan, ROC.
Chen
Yung-Che
YC
Lin
Meng-Chih
MC
Kao
Chiung-Lun
CL
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications*; D001983:Bronchial Fistula / Q000175:diagnosis* / Q000209:etiology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016157:Vascular Fistula / Q000175:diagnosis* / Q000209:etiology*