title: [A Case of Aortoesophageal Fistula Rupture Due to Descending Thoracic Aortic Dissection with Recurrent Colon Cancer during Chemotherapy Containing Bevacizumab].
abstract: We report a case of aortoesophageal fistula rupture during the course of chemotherapy following colon cancer resection. The patient was a 77-year-old woman. Following recurrence of cancer of the sigmoid colon, the patient received a course of XELOX plus bevacizumab(Bmab)to treat peritoneal dissemination and lung metastases. She was brought by ambulance to our hospital's emergency department 55 days after the last dose of Bmab, with a chief complaint of hematemesis. Hematolo- gy results showed severe anemia with a hemoglobin level of 4.0 g/dL. Descending thoracic aortic dissection was noted on chest CT with contrast, and the patient was diagnosed with an aortoesophageal fistula rupture. She underwent emergent endovascular chest stent grafting to control the bleeding. Although the ruptured esophagus was a potential source of infection, the patient and family members chose palliative treatment. Therefore, conservative treatment was administered without removing the esophagus. The patient's postoperative course was good; instead of resuming oral intake, the patient was discharged on home IVH 59 days after surgery. Outpatient follow-up continued, but multiple metastases led to gradual worsening of the patient's general condition. She died 168 days after being admitted for surgery.
authors.affiliation: Dept. of Surgery, School of Medicine, Toho University.
authors.forename: Takamaru
authors.initials: T
authors.lastname: Koda
authors.forename: Junichi
authors.initials: J
authors.lastname: Koike
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuhara
authors.forename: Akiharu
authors.initials: A
authors.lastname: Kurihara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shiokawa
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ushigome
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kaneko
authors.forename: Takayuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sawaguchi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Katayanagi
authors.forename: Takerou
authors.initials: T
authors.lastname: Fujii
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Funahashi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000009:adverse effects*; D000069287:Capecitabine; D003110:Colonic Neoplasms / Q000188:drug therapy*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004937:Esophageal Fistula / Q000209:etiology / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D010071:Oxaloacetates; D011183:Postoperative Complications; D012008:Recurrence
chemical_list: D010071:Oxaloacetates; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D005472:Fluorouracil