title: Is endovascular stent-graft treatment of primary aortoesophageal fistula worthwhile?
abstract: Aortoesophageal fistula (AEF) as a result of prolonged nasogastric intubation is rare and certainly fatal, without prompt surgical intervention. We report the case of a 41-year-old man with morbid obesity who was admitted after suffering 55% of total body surface area burns. After several skin graft operations over the course of 12 weeks, he was rushed into surgery because of the acute onset of severe upper gastrointestinal bleeding. Exploratory laparotomy and esophagogastroduodenoscopy (EGD) suggested an AEF, which was then quickly confirmed by a diagnostic angiogram. An endovascular aortic stent graft repair was performed that successfully stopped the bleeding. We include a review of the literature pertaining to cases of AEF treated by endovascular surgery, which appears to be a promising alternative to open surgery in the unfit patient.
authors.affiliation: Department of Surgery, Johns Hopkins University MD, USA.
authors.forename: Mahmoud B
authors.initials: MB
authors.lastname: Malas
authors.forename: Surajit
authors.initials: S
authors.lastname: Saha
authors.forename: Umair
authors.initials: U
authors.lastname: Qazi
authors.forename: Mark
authors.initials: M
authors.lastname: Duncan
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Perler
authors.forename: Julie A
authors.initials: JA
authors.lastname: Freischlag
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
mesh_terms: D000328:Adult; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*