Zhong XQ, Li GX. Successful management of life-threatening aortoesophageal fistula: A case report and review of the literature. World J Clin Cases 2022; 10(12): 3814-3821 [PMID: 35647167 DOI: 10.12998/wjcc.v10.i12.3814]
Corresponding Author of This Article
Guo-Xiong Li, MD, Professor, Department of Gastroenterology and Hepatology, Hangzhou Normal University Affiliated Hospital, No.126, Wenzhou Road, Hangzhou 310015, Zhejiang Province, China. guoxiongli849@hotmail.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 Clin Cases. Apr 26, 2022; 10(12): 3814-3821 Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3814
Successful management of life-threatening aortoesophageal fistula: A case report and review of the literature
Xue-Qing Zhong, Guo-Xiong Li
Xue-Qing Zhong, Guo-Xiong Li, Department of Gastroenterology and Hepatology, Hangzhou Normal University Affiliated Hospital, Hangzhou 310015, Zhejiang Province, China
Xue-Qing Zhong, Medical College, Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
Author contributions: Zhong XQ was the patient’s doctor, reviewed the literature and contributed to manuscript draft; Li GX reviewed the literature and contributed to manuscript draft; Both authors issued final approval for the version to be submitted.
Supported bythe Natural Science Foundation of Zhejiang Province (No. LQ19H030002).
Informed consent statement: As the patient died, the patient’s son informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Xiong Li, MD, Professor, Department of Gastroenterology and Hepatology, Hangzhou Normal University Affiliated Hospital, No.126, Wenzhou Road, Hangzhou 310015, Zhejiang Province, China. guoxiongli849@hotmail.com
Received: June 23, 2021 Peer-review started: June 23, 2021 First decision: July 16, 2021 Revised: July 30, 2021 Accepted: March 4, 2022 Article in press: March 4, 2022 Published online: April 26, 2022
Abstract
BACKGROUND
Aortoesophageal fistula (AEF) is a rare but life-threatening cause of upper gastrointestinal bleeding. Only a handful of cases of successful management of AEF caused by esophageal cancer have been reported. The purpose of this study is to report a case of AEF managed by endovascular aortic repair and review the relevant literature.
CASE SUMMARY
A 66-year-old man with upper gastroenterology bleeding presented at the Emergency Department of our hospital complaining of chest pain, fever and hematemesis for 6 h. He had vomited 400 mL of bright-red blood and experienced severe chest pain 6 h prior. He had a past medical history of advanced esophageal cancer. He received chemoradiotherapy but stopped 8 mo prior because of intolerance. A chest contrast computed tomographic scan revealed communication between the esophagus and the descending aorta as well as a descending aortic pseudoaneurysm. According to the symptoms and imaging findings, AEF was our primary consideration. The patient underwent aortic angiography, which indicated AEF and descending aortic pseudoaneurysm. Emergency percutaneous thoracic endovascular aortic repair (TEVAR) of the descending aorta was performed, and bleeding was controlled after TEVAR. He received antibiotics and was discharged after treatment. However, he died 2 mo after the TEVAR due to cancer progression.
CONCLUSION
Although AEF is a lethal condition, timely diagnosis and TEVAR may successfully control bleeding.
Core Tip: Aortoesophageal fistula (AEF) is a rare but life-threatening cause of upper gastrointestinal bleeding. However, only a few cases of successful management of AEF have been reported. Herein, we report the case of a 66-year-old man with life-threatening upper gastroenterology bleeding (UGB) caused by AEF who was successfully treated by thoracic endovascular aortic repair (TEVAR). The bleeding was controlled after TEVAR; he received antibiotics and was discharged. He died 2 mo later due to cancer progression. UGB caused by AEF is a lethal condition, but TEVAR is an effective treatment.
