title: Secondary aorto-esophageal fistula after esophagectomy treated with endovascular treatment: A case report.
abstract: BACKGROUND
  Aorto-esophageal fistula (AEF), a postoperative complication of esophagectomy, constitutes a very small percentage of all cases presenting with AEF; however, it is associated with a high mortality rate. Acute massive hemorrhage is the single largest cause of death in patients developing AEF. There is a lack of consensus on the optimal treatment of AEF.
  
  
  METHODS
  We present 3 cases secondary to esophagectomy due to lower thoracic esophageal carcinoma. All 3 patients presented with similar acute symptoms including a critical and life-threatening course with dead feeling, thoracic pain, and projectile hematemesis, and also hypovolemic shock.
  
  
  METHODS
  Digital subtraction angiography identified AEF as the diagnosis of these 3 cases.
  
  
  METHODS
  All patients were treated with emergency thoracic endovascular aortic repair, the aortic fistulas were repaired.
  
  
  RESULTS
  All patients successfully survived the perioperative period.
  
  
  CONCLUSIONS
  Thoracic endovascular aortic repair, a minimally invasive technique, is a better method to achieve faster and safer hemodynamic stability in patients with AEF compared with open thoracic aortic repair.
authors.affiliation: Department of Thoracic Surgery Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, P.R. China.
authors.forename: Wangang
authors.initials: W
authors.lastname: Ren
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: He
authors.forename: Xiaohang
authors.initials: X
authors.lastname: Wang
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Peng
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D057510:Endovascular Procedures; D004937:Esophageal Fistula / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016157:Vascular Fistula / Q000209:etiology / Q000601:surgery*