Aortoesophageal fistula in a patient with carcinoma of the esophagus – Case report

Aortoesophageal fistula with formation of secondary aortic pseudoaneurysm due to esophageal neoplasia: case report

“…There are no reported cases in which conservative management has been successful. Between the two reported options for invasive treatment, open surgical repair of reconstruction is associated with a higher risk of morbidity and mortality, while endovascular treatment using a stent to seal the fistula gap is considered a safer immediate alternative, particularly in hemodynamically unstable patients, with favorable short-term outcomes [2,7,9,11,12]. However, potential complications include a high rate of infection and recurrence as likely occurred in our case [6,11].…”

“…However, not all patients present this triad as in our case, where the patient did not feel pain. Most of cases in the literature were diagnosed through upper digestive endoscopy and computed tomography, which have been described as good diagnostic options [1,2,7]. Esophageal malignancy is the third most common cause of AEF due to the infiltrative and ulcerative nature of the tumor [5,6,8].…”

“…The effects of radiation vary in different tissues, with small vessels suffering from endothelial cell sloughing, fibrosis of the intimal layer with thrombosis and occlusion, while large vessels are not directly affected by the effects of radiation. However, the vasa vasorum, a small network of capillaries that supplies nutrients to the vessel walls, can thrombose, leading to necrosis and perforation of the underlying vascular wall [2,6,9]. Currently, most esophageal tumors are treated with multimodal regimens and the incidence of AEF remains restricted to rare cases, with the effects of radiation remaining uncertain on fistula formation, especially in the presence of an infiltrative and ulcerative tumor in the vicinity of the aorta [4,5].…”

“…It is a catastrophic condition that requires immediate treatment due to its high mortality rate. Thoracic aortic aneurysm, foreign body ingestion, esophageal malignancy and post-surgical complications are common causes of AEF [1,2]. However, radiationinduced AEF is a rare phenomenon, and little described in the literature, but with high lethality even in specialized centers and with immediate therapy, making prevention the best option [3][4][5].…”

pTEVAR of an aorto-esophageal fistula in esophageal cancer: Case report and review of the literature

“…The use of antimicrobial coatings on the surface of stent grafts is another option to and discussed for the future [2 , 4 , 6] . Considering these limitations, TEVAR for AEF may need subsequent open repair [6 , 13 , 14] .…”