Aorto-esophageal fistula: successful open surgical management of two cases. Issue 6 (17th June 2020)

• Record Type: Journal Article
• Authors: Pahwa, Siddharth; Bhattacharya, Susmit; Mukhopadhyay, Siddhartha; Verma, Ashok
• Is Part Of: Journal of surgical case reports. Volume 2020:Issue 6(2020)
• Publication Date: 2020-06-17
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjaa114
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: An aorto-esophageal fistula (AEF) is a rare yet life-threatening cause of upper gastrointestinal bleeding. We report our experience with open surgical management of two cases of AEF. Both cases presented with almost identical presentations: hematemesis and hemodynamic instability. The aorta in the first patient was normal; the defect was small and was repaired with a Dacron patch. The second patient had an aneurysmal aorta, which was replaced with a Dacron graft. Both cases were performed under partial bypass. The esophageal rent in both patients was debrided, primarily closed and buttressed with a vascularized intercostal pedicle. Nonavailability of endovascular personnel and equipment along with hemodynamic instability of the patient influenced our surgical strategy. Long-term follow-up of these patients is necessary to analyze the outcomes of our surgical repair.