Peptic ulcer-induced acute aortogastric fistula occurring 7 years after a pharyngogastrostomy following a resection for carcinoma of the esophagus: report of a case.
A 46-year-old woman underwent a pharyngogastrostomy, following a laryngoesophagectomy for esophageal carcinoma. Although she had been disease-free for 7 years, she subsequently was admitted to undergo a workup due to fever along with chest and back pain. A few days after admission, the patient suddenly vomited a large volume of blood and went into shock. Bleeding was stopped with a Sengstaken-Blakemore tube, and an emergency thoracotomy was performed. A fistula between the thoracic aorta and an ulcer of the gastric tube was identified. We decided to close the aortic lesion directly because the adhesions were extremely dense and her blood circulation was poor. One week later, we resected the thoracic part of the gastric tube, debrided the fistula, and wrapped the aortic lesion with a patch. However, on the 18th postoperative day, she developed massive hematemesis due to rupture of an infected pseudoaneurysm in the thoracic aorta and died.
Takebayashi
Tetsuro
T
Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Okushiba
Shunichi
S
Ohno
Koichi
K
Ito
Kiyotaka
K
Sato
Kosaku
K
Morikawa
Toshiaki
T
Kondo
Satoshi
S
Katoh
Hiroyuki
H
D000208:Acute Disease; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005747:Gastric Fistula / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications*; D010613:Pharyngostomy / Q000009:adverse effects*; D013997:Time Factors