Acute aortogastric fistula following gastro-oesophageal anastomosis

Lau, O. J.

doi:10.1002/bjs.1800700816

Cited by 15 publications

(7 citation statements)

References 3 publications

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“…Destruction of the mucosal barrier due to relative ischemia in the gastric tube, hypersecretion of gastric acid, postoperative radiation, and Helicobacter pylori infection are the etiology of peptic ulcer in the gastric tube. 6,13 Although the existence of a H. pylori infection is considered to be important, a urease test was not performed in this case.…”

Section: Discussionmentioning

confidence: 98%

Peptic Ulcer-Induced Acute Aortogastric Fistula Occurring 7 Years After a Pharyngogastrostomy Following a Resection for Carcinoma of the Esophagus: Report of a Case

et al. 2004

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A 46-year-old woman underwent a pharyngogastrostomy, following a laryngoesophagectomy for esophageal carcinoma. Although she had been disease-free for 7 years, she subsequently was admitted to undergo a workup due to fever along with chest and back pain. A few days after admission, the patient suddenly vomited a large volume of blood and went into shock. Bleeding was stopped with a Sengstaken-Blakemore tube, and an emergency thoracotomy was performed. A fistula between the thoracic aorta and an ulcer of the gastric tube was identified. We decided to close the aortic lesion directly because the adhesions were extremely dense and her blood circulation was poor. One week later, we resected the thoracic part of the gastric tube, debrided the fistula, and wrapped the aortic lesion with a patch. However, on the 18th postoperative day, she developed massive hematemesis due to rupture of an infected pseudoaneurysm in the thoracic aorta and died.

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Section: Discussionmentioning

confidence: 98%

Peptic Ulcer-Induced Acute Aortogastric Fistula Occurring 7 Years After a Pharyngogastrostomy Following a Resection for Carcinoma of the Esophagus: Report of a Case

et al. 2004

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“…Penetration of a gastric tube ulcer into vital organs in the mediastinum, however, is a noteworthy complication following this type of reconstruction because of its lethal consequences. Ulcer in the gastric tube has been reported to form fi stulas to the aorta [9,10], the trachea [11], and the pericardium [12], and results of treatment of these complications have been dismal. Most of the patients who suffered from these fi stulas had been treated with retromediastinal reconstruction whereby vital organs exist around the gastric tube.…”

Section: Discussionmentioning

confidence: 99%

Gastroventricular fistula: severe complication of posterior mediastinal gastric tube reconstruction after esophagectomy

et al. 2008

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“…The mechanisms for this problem are quite variable, and may involve thoracic or abdominal aortic aneurysms, [16][17][18][19] gastrostomy tube-related bleeding, 20 erosion into a esophagogastrostomy, 21 arterial bleeding into a duodenal stump, 22 or others. [23][24][25][26] All these above cases resulted in fatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Successful Management and Outcome of a Postoperative Aortogastric Fistula in a Patient with Recurrent Gastric Cancer: Report of a Case

Schwarz¹,

Marx

Andersen

2002

Surgery Today

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The case of a 57-year-old patient is described, who presented with regional gastric cancer recurrence 1 year after a gastrectomy for a T3N1M0 (Stage IIIA) adenocarcinoma of the stomach. He underwent a radical resection with intraoperative radiation to the regional field. Two months postoperatively, massive upper gastrointestinal bleeding occurred. Operative management included a left thoracotomy, aortic cross-clamping, laparotomy, and suture repair of a fistula from the root of the celiac trunk to the gastric remnant, with a completion gastrectomy. The patient survived and underwent a delayed reconstruction and closure. Subsequently, several repeat bleeding episodes took place, from sources including the celiac, common hepatic, and proper hepatic arteries. Multiple angiographic coil embolization and surgical procedures became necessary, ultimately requiring an esophagostomy and cecostomy for intestinal diversion. A rectus abdominis flap coverage of the exposed large arteries was performed. Although two more bleeding episodes took place, the patient was ultimately managed successfully. He is currently free of disease 3 years after reexploration, able to take oral nutrition, with intermittent jejunostomy feeding supplements. The discussion highlights aspects relevant to this case: the importance of a complete regional resection during a gastric cancer resection, the management strategy for an acute catastrophic intra-abdominal bleeding, and possible mechanisms that could contribute to such bleeding, including intraoperative radiation and postoperative infection.

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Acute aortogastric fistula following gastro-oesophageal anastomosis

Cited by 15 publications

References 3 publications

Peptic Ulcer-Induced Acute Aortogastric Fistula Occurring 7 Years After a Pharyngogastrostomy Following a Resection for Carcinoma of the Esophagus: Report of a Case

Peptic Ulcer-Induced Acute Aortogastric Fistula Occurring 7 Years After a Pharyngogastrostomy Following a Resection for Carcinoma of the Esophagus: Report of a Case

Gastroventricular fistula: severe complication of posterior mediastinal gastric tube reconstruction after esophagectomy

Successful Management and Outcome of a Postoperative Aortogastric Fistula in a Patient with Recurrent Gastric Cancer: Report of a Case

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