Fistula between subclavian arterial graft and oesophagus.
This is the first reported case of an oesophageal fistula arising from a subclavian arterial graft. A 28 year-old woman presented with massive haematemesis in severe haemorrhagic shock, three months after surgery to detach and relocate an aberrant right subclavian artery. Acutely, she was haemodynamically unstable and required transfusion of 45 units of blood. The fistula was identified with angiography (via the right brachial artery) after endoscopic and open visualisation were unsuccessful because of the torrential haemorrhage. The patient was stabilised and the fistula was managed with an endovascular covered stent. She had further surgery subsequently to remove the infected graft and to salvage the right arm.
Cardiology Program, The Prince Charles Hospital, Chermside, Qld 4032, Australia; University of Queensland, School of Medicine, Herston, Qld 4006, Australia.
Alexander
A
Incani
Division of Medical Imaging, The Prince Charles Hospital, Chermside, Qld 4032, Australia; University of Queensland, School of Medicine, Herston, Qld 4006, Australia. Electronic address: Joseph_Lee@health.qld.gov.au.
Joseph C
JC
Lee
Cardiology Program, The Prince Charles Hospital, Chermside, Qld 4032, Australia.
Karl K
KK
Poon
Department of Cardiothoracic Surgery, The Prince Charles Hospital, Chermside, Qld 4032, Australia.
Peter G
PG
Pohlner
Cardiology Program, The Prince Charles Hospital, Chermside, Qld 4032, Australia; University of Queensland, School of Medicine, Herston, Qld 4006, Australia.
Darren L
DL
Walters
D000328:Adult; D004937:Esophageal Fistula / Q000209:etiology* / Q000601:surgery; D005260:Female; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D015607:Stents; D013348:Subclavian Artery; D016157:Vascular Fistula / Q000209:etiology* / Q000601:surgery; D058017:Vascular Grafting / Q000009:adverse effects*