title: A case of secondary aortoesophageal fistula inserted a covered self-expanding esophageal stent to control gastrointestinal bleeding.
abstract: A 73-year-old man presented with melena. After a thorough workup including esophageal endoscopy, computed tomography scans, and esophagography, the diagnosis of secondary aortoesophageal fistula was made. Two years previously, he had undergone endovascular stent-graft repair for the dissection of his descending thoracic aorta. Because of the generally poor condition of the patient and the high risk of any aggressive surgical intervention, we inserted a covered self-expanding esophageal stent on postadmission day 18. Esophagography after insertion did not show any evidence of a leak of contrast medium. Despite treatment with antibiotics, he developed sepsis and expired on day 52, but rebleeding did not occur in this period. We consider insertion of a covered self-expanding esophageal stent as a feasible option in the management of secondary aortoesophageal fistula in high-risk patients.
authors.affiliation: Iwate Medical University, School of Medicine, Department of Emergency Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Onodera
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Endo