title: Endoscopic diagnosis of a clinically silent aortoesophageal fistula: case report and review of the literature.
abstract: We report a rare case of a secondary aortoesophageal fistula discovered incidentally during elective upper endoscopy. The patient had previously undergone repair of a descending thoracic aortic aneurysm with a Dacron interposition graft. Esophagoscopy 2 months after the aneurysm repair demonstrated a large mid-esophageal erosion with visualization of the aortic graft at the base. The aortoesophageal fistula had been clinically silent to this point. During preparation for surgery the patient developed large-volume esophageal hemorrhage and died following attempted endovascular repair of the fistula. A review of the literature on the diagnosis and surgical management of aortoesophageal fistula is presented.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA 98431-1100, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.forename: Scott
authors.initials: S
authors.lastname: Steele
authors.forename: Philip
authors.initials: P
authors.lastname: Mullenix
authors.forename: Mohamad
authors.initials: M
authors.lastname: Haque
authors.forename: Charles
authors.initials: C
authors.lastname: Andersen
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000601:surgery; D020776:Endoscopes, Gastrointestinal; D004937:Esophageal Fistula / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures