[Chronic contained rupture of a descending thoracic aortic aneurysm simulating an esophagus tumor. Conventional surgical management].
The authors report the clinic case of a 54 years old male, whose chief complaints were dysphagia for solid foods, epigastralgias and remarkable weight loss, of 20 kilos in two months. Admitted in another hospital with the diagnosis of esophagus tumor, an upper G.I. endoscopy disclosed an extensive external compresion of the esophagus middle third and the CT-chest scans revealed a large descending thoracic aortic aneurysm, in chronic contained rupture, as the cause of the compression. The patient was immediately transferred to our hospital and underwent the conventional surgical management, consisting in the aneurysm resection and replacement with a 30 mm Dacron prosthesis. The post-operative course was uneventful and reviewed four months following the operation he was found in good condition, asymptomatic and displaying a remarkable weight gain. In era of a progressive expansion of the field of the endovascular management of thoracic aortic aneurysms, some cases, like the present clinical case, seem to represent a formal contraindication to the endovascular technology, due to the irreducible external compression of organs such as the esophagus, thus remaining an exclusive indication for the conventional surgical management.
Clínica Universitária de Cirurgia Vascular e Serviço de Anestesia do Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa.
A Dinis
AD
da Gama
Carlos
C
Martins
Gonçalo
G
Cabral
A Garcia
AG
Alves
D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures / Q000379:methods