Primary aortoesophageal fistula due to thoracic aortic aneurysm: successful surgical treatment.
Aortoesophageal fistula is a rare emergency that presents a real challenge for cardiothoracic surgeons. There have been few reports of survivors. We present the case of a 70-year-old man with aortoesophageal fistula, mediastinal abscess, and severe septicemia consequent to esophageal erosion and rupture of a chronic degenerative descending thoracic aortic aneurysm. The patient underwent successful surgical treatment by aorto-aortic bypass and bipolar esophageal exclusion in conjunction with a cervical esophagostomy and a feeding gastrostomy. The pleural cavity was copiously irrigated and drained. Three months later, a retrosternal gastric bypass operation was performed successfully. The patient's 6-month follow-up examination revealed no problems.
Prokakis
Christos
C
Department of Cardiothoracic Surgery, School of Medicine, University of Patras, 26500 Patras, Greece.
Charoulis
Nikolaos
N
Tselikos
Dimitrios
D
Koletsis
Efstratios N
EN
Apostolakis
Efstratios
E
Dougenis
Dimitrios
D
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D003646:Debridement; D004322:Drainage; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy; D004946:Esophagostomy; D015390:Gastric Bypass; D005774:Gastrostomy; D006801:Humans; D008297:Male; D007507:Therapeutic Irrigation; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*