Surgical treatment of an aortoesophageal fistula caused by stent implantation for esophageal stenosis: report of a case.
An aortoesophageal fistula is uncommon, but almost always fatal. We report a case of an aortoesophageal fistula that developed after stent dilation for an esophageal stricture caused by benign esophagitis. As soon as esophageal hemorrhaging was identified by endoscopy, the patient was transferred to the operating theater; however, the uncontrollable and massive bleeding resulted in pulseless shock. The digestive surgeon put side-clamps on the descending aorta and esophagus and transferred the patient to our hospital. We identified an aortoesophageal fistula, 3.0 mm in diameter, in the descending aorta, and performed a graft replacement of the descending aorta and esophagectomy. It was immediately evident that the edge of the stent had been sticking into the aortic wall, which had caused the fistula. To our knowledge, this is the first report of successful surgical treatment of an aortoesophageal fistula caused by esophageal stent dilatation.
Unosawa
Satoshi
S
Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Ohyaguchi-Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
Hata
Mitsumasa
M
Sezai
Akira
A
Niino
Tetsuya
T
Yoda
Masataka
M
Shimura
Kazuma
K
Furukawa
Nobuyuki
N
Minami
Kazutomo
K
D001013:Aorta, Thoracic; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003937:Diagnosis, Differential; D004937:Esophageal Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy; D004945:Esophagoscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D013902:Radiography, Thoracic; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D016157:Vascular Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*