Successful Management of Secondary Aortoesophageal Fistula with Graft Infection

Iguchi, A.; Miyazaki, Shukichi; Akimoto, Hiroji; Ohmi, M; Tabayashi, Koichi

doi:10.1055/s-2001-11707

Cited by 13 publications

(9 citation statements)

References 4 publications

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“…Temporary or permanent extra-anatomic bypass can be performed in the presence of no active bleeding. However, mediastinitis, sepsis, and bleeding are common complications after surgical treatment of AEF, and this treatment option has high morbidity and mortality rates [17]. Recently, stent-graft placement has been successfully used to treat secondary AEF after surgery.…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

Numan

Gülşen

Cantasdemir

et al. 2011

Cardiovasc Intervent Radiol

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A 68-year-old man who was subjected to stent-grafting of a descending thoracic aortic aneurysm (TAA) 4 months previously was admitted to our hospital with constitutional symptoms, including high fever, sweating, nausea, vomiting, weight loss, and backache. An infected aneurysmal sac was suspected based on computed tomography (CT) findings, and an aortoesophageal fistula (AEF) was identified during esophagoscopy. CT-guided aspiration was performed using a 20-G Chiba needle, confirming the presence of infection. For treatment of the infected aneurysmal sac, CT-guided percutaneous catheter drainage in a prone position was performed under general anesthesia with left endobronchial intubation. Drainage catheter insertion was successfully performed using the Seldinger technique, which is not a standard treatment of an infected aneurysmal sac. Improvement in the patient's clinical condition was observed at follow-ups, and CT showed total regression of the collection in the aneurysmal sac.

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Section: Discussionmentioning

confidence: 98%

Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

Numan

Gülşen

Cantasdemir

et al. 2011

Cardiovasc Intervent Radiol

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“…Thoracic aortic aneurysm is the cause of aortoesophageal fistula in over half of the reported cases 1,2 . Malignant neoplasms, mediastinal infections, atherosclerotic aortic ulcers without aneurysmal dilatation, as well as history of repair of congenital cardiac conditions have also been cited as causative agents 1,2,4 …”

Section: Discussionmentioning

confidence: 99%

“…The main causes of aortoesophageal fistulas include thoracic aortic aneurysm, foreign bodies, malignancy and postoperative trauma. Approximately 500 cases have been reported in the literature 1,2 . Among these, we recently gathered 4 cases of aortoesophageal fistulas resulting from a perforation of an esophageal ulcer developed within Barrett's mucosa, i.e.…”

Section: Introductionmentioning

confidence: 99%

Aortoesophageal fistula of uncommon origin: perforation of a Barrett’s ulcer

Guillem¹,

Porte²,

Techer³

et al. 2003

Diseases of the Esophagus

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Aortoesophageal fistulas are life-threatening conditions of which over half are secondary to thoracic aortic aneurysms. Four cases related to perforation of a Barrett's ulcer have been described so far, accounting for less than 1% of published aortoesophageal fistulas. We report a fifth case, which presented with severe hypotension, anemia and hematemesis. The patient underwent emergency esophagectomy and aortic closure but postoperatively required aortic endoprosthesis for residual bleeding. This case highlights the great diagnostic and therapeutic challenge associated with perforated Barrett's ulcer.

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“…Erfolgreiche chirurgische Therapien sind beschrieben und scheinen mehrheitlich in einem ausgedehnten chirurgischen Eingriff zu bestehen, wobei im Allgemeinen eine linksseitige Thorakotomie, eine Resektion der Aortenprothese, ein Aortenersatz durch ein (Homo)graft, eine Abdeckung durch ein biologisches Material wie Omentum oder Pleura und eine Resektion von Ösophagus und Abszess/Fistelmaterial durchgeführt wird [1,7,21]. Ein operatives Vorgehen ist bei Patienten nach TEVAR jedoch mit einer hohen Mortalität verbunden und oft durch schwere Blutungen, Mediastinitis und Sepsis verkompliziert [11]. Weiterhin sind viele Patienten von vornherein aufgrund bedeutsamer Komorbiditäten de facto inoperabel, weshalb zur Behandlung der aortalen Grunderkrankung ursprünglich ja gerade das interventionelle Vorgehen bevorzugt wurde.…”

Section: Therapie Und Verlaufunclassified