title: A Fatal Aortoesophageal Fistula Caused by Critical Combination of Double Aortic Arch and Nasogastric Tube Insertion for Superior Mesenteric Artery Syndrome.
abstract: Double aortic arch (DAA) is a rare vascular congenital abnormality. Since a vascular ring surrounds bronchus and esophagus, any oral or nasal intubation can physically cause fatal aortoesophageal fistula (AEF). We report herein the first case of association of DAA and superior mesenteric artery (SMA) syndrome and the second case of AEF caused by nasogastric intubation in an adult with DAA. A 19-year-old woman visited our hospital for nausea and vomiting. She was diagnosed with SMA syndrome by computed tomography (CT). Nasogastric intubation relieved her symptoms in 4 days. Extramural compression with top ulceration was found in esophagogastroduodenoscopy on the 5th hospital day. She suddenly showed massive hematemesis on the 12th hospital day. AEF was found by CT. Soon, she died despite of intensive care. Retrospective interview disclosed the fact that DAA was pointed out in her childhood. We conclude that intubation must be avoided in DAA and a detailed clinical interview about DAA is mandatory to avoid AEF.
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Miura
authors.forename: Junichiro
authors.initials: J
authors.lastname: Nakamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Miura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yanagi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Tani
authors.forename: Mamiko
authors.initials: M
authors.lastname: Nishihara
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
references.citation: Mayo Clin Proc. 1993 Nov;68(11):1056-63
references.pmid: 8231269
references.citation: Pediatrics. 2006 Nov;118(5):e1336-41
references.pmid: 17000782
references.citation: World J Gastroenterol. 2008 Apr 28;14(16):2590-2
references.pmid: 18442212
references.citation: Can J Anaesth. 1992 Oct;39(8):894
references.pmid: 1288917
references.citation: Tex Heart Inst J. 1993;20(2):126-9
references.pmid: 8334365
references.citation: Vasa. 2000 Feb;29(1):77-9
references.pmid: 10731894
references.citation: Jpn J Thorac Cardiovasc Surg. 2005 Apr;53(4):223-6
references.pmid: 15875561
references.citation: Respiration. 2002;69(1):92-5
references.pmid: 11844971
references.citation: Dig Surg. 2007;24(3):149-56
references.pmid: 17476104
references.citation: Eur J Pediatr. 2006 Sep;165(9):660-1
references.pmid: 16642369
references.citation: J Pediatr Surg. 1990 Dec;25(12):1298-300
references.pmid: 2286914
references.citation: J Med Assoc Thai. 2004 Aug;87(8):992-5
references.pmid: 15471308
references.citation: J Pediatr Surg. 1996 Apr;31(4):594-5
references.pmid: 8801321
references.citation: Cardiol Young. 2002 Mar;12(2):172-6
references.pmid: 12018723
references.citation: J Pediatr Surg. 2006 Apr;41(4):848-9
references.pmid: 16567207