title: Successful treatment of an aortoesophageal fistula after emergency endovascular thoracic aortic stent-graft placement.
abstract: We report the case of a 57-year-old man who underwent emergency stent-graft placement in August 2003 due to a contained rupture of a distal descending aortic aneurysm. After 1 month the patient was readmitted with chest pain as well as swallowing disorders. A computed tomographic scan revealed a fistula between the distal esophagus and the excluded aneurysm sac. The patient was treated by an esophagectomy, a cervical esophagostomy, as well as a feeding gastrostomy. The infectious parietal thrombus was partially debrided and the aneurysm sac was filled with vancomycin. After 3 months continuity was reinstalled with a pedicled isoperistaltic transverse colonic conduit. The patient recovered uneventfully. At a 3 month follow-up, he showed no signs of infection. However, he is still being treated with antibiotic therapy of ciprofloxacin for a minimum of 1 year.
authors.affiliation: Department of Cardiothoracic Surgery, University of Vienna Medical School, Vienna, Austria. bypass@eunet.at
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
authors.forename: Tatjana
authors.initials: T
authors.lastname: Fleck
authors.forename: Roman
authors.initials: R
authors.lastname: Gottardi
authors.forename: Manfred
authors.initials: M
authors.lastname: Cejna
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Ernst
authors.initials: E
authors.lastname: Wolner
authors.forename: Martin
authors.initials: M
authors.lastname: Grabenwoger
authors.forename: Michael-Rolf
authors.initials: MR
authors.lastname: Mueller
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004937:Esophageal Fistula / Q000209:etiology* / Q000601:surgery*; D016629:Esophagectomy; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000601:surgery; D015607:Stents; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000209:etiology* / Q000601:surgery*