Aortoesophageal fistula: a life-threatening cause of upper gastrointestinal hemorrhage in double aortic arch, a case report.
The authors present the case of a 2-month-old infant with double aortic arch that developed massive bright red upper gastrointestinal hemorrhage from aortoesophageal fistula (AEF) after prolonged endotracheal and nasogastric intubation. Emergency thoracotomy with AEF and double aortic arch repaired were done successfully under cardiopulmonary bypass. Due to tracheomalacia and left phrenic nerve injury, tracheal extubation could not be done until 1 month after correction of the vascular ring. The endotracheal and nasogastric tube led to fistula formation by compression of the esophageal wall against an abnormal double aortic arch. When a double aortic arch is suspected, prolonged nasogastric intubation should be avoided.
Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Thailand. arncha@kku.ac.th
Arnkisa
A
Chaikitpinyo
Manat
M
Panamonta
Sumitr
S
Sutra
Cherdchai
C
Tontisirin
Jiraporn
J
Srinakarin
Yuttapong
Y
Wongswadiwat
D001013:Aorta, Thoracic / Q000002:abnormalities*; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D004937:Esophageal Fistula / Q000150:complications / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male