Primary aortoesophageal fistula : Presenting as massive upper gastrointestinal hemorrhage

Abstract

Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. Endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.

Survival in a 2-year-old boy with hemorrhage secondary to an aortoesophageal fistula

“…A previous case [8] published in 1996 described a 6-yearold boy whose endoscopy after massive hematemesis showed a "submucosal bulge with an overlying ulcer and clot" in the esophagus that was not bleeding at the time. Unfortunately, their patient died prior to surgical repair of the fistula.…”

Aortoesophageal fistula in a child

“…[8] An aortic aneurysm can sometimes erode the esophagus, leading to the formation of a communication between aorta and esopahagus. [9] One case of a child developing AEF due to severe esophagitis caused by ingestion of a Dieffenbachia leaf has been reported. [10]A case has been reported in a child, where AEF was found peri-operatively, but no cause could be ascertained.…”