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

Coates, Laura J.; McNally, Janet; Caputo, Massimo; Cusick, Eleri

doi:10.1016/j.jpedsurg.2011.09.054

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…This is because of the different aetiologias in pediatric and adult patients; the most common cause in adults is thoracic aortic aneurysm, which is rare among children. Endoscopy findings varied in reported cases, and included pulsatile or fresh bleeding [ 11 , 12 , 40 ], pulsatile submucosal hematoma [ 44 ], a non-pulsatile purple mass protruding into the esophagus in the aneurysm [ 36 ], esophageal ulcer with [ 18 ] or without bleeding [ 13 ], thickened mucosa [ 21 ], and an odd purple streak [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

A 2-Year-Old Boy Who Developed an Aortoesophageal Fistula After Swallowing a Button Battery, Managed Using a Novel Procedure with Vascular Plug Device as a Bridge to Definitive Surgical Repair

et al. 2021

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Patient: Male, 2-year-old Final Diagnosis: Aortoesophageal fistula Symptoms: Esophageal foreign body • gastrointestinal bleeding Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology • Pediatrics and Neonatology Objective: Rare disease Background: Button batteries (BBs) can be inhaled or swallowed accidentally, particularly by infants and children, who can present as a surgical emergency with a fatal outcome. This report is of a case of a 2-year-old boy who developed an aortoesophageal fistula (AEF) after swallowing a button battery and was successfully treated using a novel vascular plug device as a bridge to definitive surgical repair. AEF is diagnosed using computed tomography angiography (CTA), after laparotomy, and using aortography. Aortic endovascular stenting and vascular occluder placement is a minimally invasive emergency option until definitive treatment can be provided. The surgical options include repair the aortic defect primarily, or the diseased segment of the aorta is replaced with a graft. Case Report: A 2-year-old boy presented with hematemesis 9 days after ingestion of a button battery, which was removed endoscopically 16 hours after the incident. The patient was resuscitated aggressively and diagnosed to have AEF using computed tomography angiography (CTA). The aorta was successfully repaired using a vascular plug device, which kept the patient safe until the definitive surgical treatment was done 2 months later. The defect was repaired with direct anastomosis and completed with a patch of bovine pericardium, as well as closure of the fistula from the esophageal side with stitches. Conclusions: This report presents a rare but previously reported complication of swallowing a button battery, resulting in an aortoesophageal fistula. The aorta was successfully repaired using a vascular plug as a minimally invasive emergency option, which is considered as a lifesaving procedure and a bridge for definitive repair.

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Section: Discussionmentioning

confidence: 99%

A 2-Year-Old Boy Who Developed an Aortoesophageal Fistula After Swallowing a Button Battery, Managed Using a Novel Procedure with Vascular Plug Device as a Bridge to Definitive Surgical Repair

et al. 2021

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“…A Sengstaken–Blakemore tube (SBT) has been successfully used to temporarily tamponade bleeding before more definitive surgical repair . However, the maximum oesophageal balloon pressure the SBT carries is only 35 mmHg, which in theory would only abate venous haemorrhage consistently .…”

Section: Discussionmentioning

confidence: 99%

Hidden danger of button batteries

Taghavi

Hobson

Borzi

2014

J Paediatrics Child Health

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“…Inflatable gastroesophageal balloons have been reported to decrease aortoesophageal fistula blood loss prior to definitive surgical repair. [16][17][18] In patients with ruptured aortoesophageal fistula, aggressive volume resuscitation perioperatively are critical to patient survival. 18 In this challenging pediatric patient, the difficulty in confirming the diagnosis was related to a very uncommon presentation of upper gastrointestinal bleed.…”

Section: Discussionmentioning

confidence: 99%