Successful surgical treatment of aortoesophageal fistula after esophagectomy.
We report a 65-year-old man with complications of aortoesophageal fistula after esophagectomy. A combined middle-lower esophagectomy with remnant gastrectomy was performed for esophageal cancer. The alimentary tract was restored by intrathoracic esophagojejunal anastomosis using a surgical stapler. Twenty-four days later the patient suddenly had hypovolemic shock develop due to aortoesophageal fistula. We performed emergency surgery, and the aortic fistula was directly closed with a 3-0 monofilament using abdominal fascia as a pledget. Thirty-eight days later, alimentary reconstruction was performed using a free jejunal graft. Aortic pseudoaneurysm due to direct closure was predictably detected, and transluminal endovascular stent grafting was indicated.
Okita
Riki
R
Department of Surgery, Hiroshima Asa City Hospital, Hiroshima, Japan. rokita@shikoku-cc.go.jp
Mukaida
Hidenori
H
Takiyama
Wataru
W
Oheda
Mamoru
M
Uchida
Naomichi
N
Ishihara
Hiroshi
H
D000368:Aged; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery*; D004937:Esophageal Fistula / Q000209:etiology* / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012074:Remission Induction; D016157:Vascular Fistula / Q000209:etiology* / Q000601:surgery*