title: Survival following Treatment of Aortoesophageal Fistula with Dual Esophageal and Aortic Intervention.
abstract: Aortoesophageal fistulas are a rare but commonly fatal complication of esophageal cancer. Reports of successfully managed cases are few, with high mortality and morbidity usually resulting from failure to control the initial massive haemodynamic insult. We report the case of a 47-year-old Caucasian man with recently diagnosed advanced esophageal cancer who suffered an episode of massive haematemesis. Emergency gastroscopy revealed an arterial bleeding point in the proximal esophagus. A self-expanding metal esophageal stent was placed to achieve initial partial haemostasis. CT angiography confirmed an aortoesophageal fistula. An endoluminal stent device was thus inserted within the thoracic aorta stabilising the bleeding point. The patient subsequently made an uneventful recovery and was discharged on long-term antibiotics for palliative care. He survived for 2 months at home before dying of disseminated malignancy. The successful use of esophageal stenting as a means of achieving haemostasis, allowing time for endovascular intervention, is as yet a relatively unexplored area of management of this rare condition.
authors.affiliation: Department of Gastroenterology, University College Hospital, London, UK.
authors.forename: Soumitra K
authors.initials: SK
authors.lastname: Ghosh
authors.forename: Farooq Z
authors.initials: FZ
authors.lastname: Rahman
authors.forename: Stephen
authors.initials: S
authors.lastname: Bown
authors.forename: Peter
authors.initials: P
authors.lastname: Harris
authors.forename: Kevin
authors.initials: K
authors.lastname: Fong
authors.forename: Louise
authors.initials: L
authors.lastname: Langmead