Martino A, Oliva G, Zito FP, Silvestre M, Bennato R, Orsini L, Niola R, Romano L, Lombardi G. Acute upper gastrointestinal bleeding caused by esophageal right bronchial artery fistula: A case report. World J Gastrointest Endosc 2021; 13(11): 565-570 [PMID: 34888008 DOI: 10.4253/wjge.v13.i11.565]
Corresponding Author of This Article
Alberto Martino, MD, Staff Physician, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Via Antonio Cardarelli 9, Napoli 80131, Italy. albertomartinomd@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Nov 16, 2021; 13(11): 565-570 Published online Nov 16, 2021. doi: 10.4253/wjge.v13.i11.565
Acute upper gastrointestinal bleeding caused by esophageal right bronchial artery fistula: A case report
Alberto Martino, Gaspare Oliva, Francesco Paolo Zito, Mattia Silvestre, Raffaele Bennato, Luigi Orsini, Raffaella Niola, Luigia Romano, Giovanni Lombardi
Alberto Martino, Francesco Paolo Zito, Raffaele Bennato, Luigi Orsini, Giovanni Lombardi, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Gaspare Oliva, Luigia Romano, Department of General and Emergency Radiology, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Mattia Silvestre, Raffaella Niola, Department of Interventional Radiology, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Author contributions: Martino A, Oliva G was responsible for the conception of the paper; Martino A, Oliva G, Zito FP, Silvestre M, Bennato R and Orsini L drafting of the article, interpretation of the data and final approval of the article; Martino A execution of the endoscopic procedures; Oliva G execution of the diagnostic radiological examinations; Silvestre M execution of the interventional radiological procedures; Niola R, Romano L and Lombardi G analysis and interpretation of data, revision of the manuscript for important intellectual content and final approval of the article.
Informed consent statement: Informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: No conflict of interest declared.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alberto Martino, MD, Staff Physician, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Via Antonio Cardarelli 9, Napoli 80131, Italy. albertomartinomd@gmail.com
Received: June 29, 2021 Peer-review started: June 29, 2021 First decision: July 27, 2021 Revised: August 4, 2021 Accepted: October 15, 2021 Article in press: October 15, 2021 Published online: November 16, 2021
Abstract
BACKGROUND
Fistula between the esophagus and bronchial artery is an extremely rare and potentially life-threatening cause of acute upper gastrointestinal bleeding. Here, we report a case of fistula formation between the esophagus and a nonaneurysmal right bronchial artery (RBA).
CASE SUMMARY
An 80-year-old woman with previous left pneumonectomy and recent placement of an uncovered self-expandable metallic stent for esophageal adenocarcinoma was admitted due to hematemesis. Emergent computed tomography showed indirect signs of fistulization between the esophagus and a nonaneurysmal RBA, in the absence of active bleeding. Endoscopy revealed the esophageal stent correctly placed and a moderate amount of red blood within the stomach, in the absence of active bleeding or tumor ingrowth/overgrowth. After prompt multidisciplinary evaluation, a step-up approach was planned. The bleeding was successfully controlled by esophageal restenting followed by RBA embolization. No signs of rebleeding were observed and the patient was discharged home with stable hemoglobin level on postoperative day 7.
CONCLUSION
This was a previously unreported case of an esophageal RBA fistula successfully managed by esophageal restenting followed by RBA embolization.
Core Tip: Esophageal bronchial artery fistula is an extremely rare cause of upper gastrointestinal bleeding. Here, we describe a previously unreported case of fistula formation between the esophagus and a nonaneurysmal right bronchial artery (RBA), in the setting of palliative esophageal metallic stenting and previous left pneumonectomy. Hemostasis was achieved by the use of esophageal restenting followed by RBA embolization.
