Is endovascular stent-graft treatment of primary aortoesophageal fistula worthwhile?

Vasc Endovascular Surg. 2011 Jan;45(1):83-9. doi: 10.1177/1538574410380793. Epub 2010 Aug 31.

Abstract

Aortoesophageal fistula (AEF) as a result of prolonged nasogastric intubation is rare and certainly fatal, without prompt surgical intervention. We report the case of a 41-year-old man with morbid obesity who was admitted after suffering 55% of total body surface area burns. After several skin graft operations over the course of 12 weeks, he was rushed into surgery because of the acute onset of severe upper gastrointestinal bleeding. Exploratory laparotomy and esophagogastroduodenoscopy (EGD) suggested an AEF, which was then quickly confirmed by a diagnostic angiogram. An endovascular aortic stent graft repair was performed that successfully stopped the bleeding. We include a review of the literature pertaining to cases of AEF treated by endovascular surgery, which appears to be a promising alternative to open surgery in the unfit patient.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / etiology
  • Aortic Diseases / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / instrumentation*
  • Esophageal Fistula / diagnostic imaging
  • Esophageal Fistula / etiology
  • Esophageal Fistula / surgery*
  • Fatal Outcome
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Intubation, Gastrointestinal / adverse effects
  • Male
  • Stents*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular Fistula / diagnostic imaging
  • Vascular Fistula / etiology
  • Vascular Fistula / surgery*