Secondary infection of a pre-existing thoracic aortic aneurysm by iatrogenic oesophageal perforation with aorta-oesophageal fistula formation.
We report a case of iatrogenic perforation of the oesophagus, with subsequent infection of a pre-existing thoracic aortic aneurysm and development of an aorto-oesophageal fistula resulting in life-threatening haemorrhage. This was successfully treated with endovascular aortic stent-graft using a Cook Zenith Tx2 device. Follow-up CT scan 3 months later showed that the aneurysm sac is getting smaller, and patient had no further septic or haemorrhagic complications. However, we emphasise that even if initial endovascular management of aorto-oesophageal fistula is successful, these patients often risk recurrent sepsis and therefore long-term clinical and radiological surveillance is mandatory.
Chan
Yiu Che
YC
Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong.
Ting
Albert C
AC
Law
Simon
S
Cheng
Stephen W
SW
D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000209:etiology; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology*; D001018:Aortic Diseases / Q000150:complications; D004937:Esophageal Fistula / Q000150:complications*; D004939:Esophageal Perforation / Q000150:complications*; D004947:Esophagus / Q000293:injuries; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000150:complications