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International Angiology 2000 September;19(3):290-293

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English

Primary aorto-oesophageal fistula due to oesophageal carcinoma. Report of a successfully managed case

Cairols M. A., Izquierdo L. M., Barjau E., Iborra E., Romera A.

From the Service of Vascular Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain


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Aorto-oesoph­a­geal fis­tu­la is a rare but often fatal ­entity caus­ing upper gas­troin­tes­ti­nal bleed­ing. ­Amongst the dif­fer­ent aetio­lo­gies ­described, the com­mon­est is rup­ture of a tho­rac­ic aor­tic aneu­rysm into the oesoph­a­gus. This ­entity was first report­ed in 1818, and only recent­ly have suc­cess­ful­ly treat­ed cases been pub­lished. Other caus­es such as post­op­er­a­tive com­pli­ca­tions, tuber­cu­lo­sis and trau­ma are less com­mon. Oesoph­a­geal malig­nan­cy per­fo­rat­ing the aorta is a rar­ity. The ­authors ­describe a case of aor­tic per­fo­ra­tion sec­on­dary to an oesoph­a­geal car­ci­no­ma, treat­ed with ­initial suc­cess. The clin­i­cal onset was a mas­sive upper gas­troin­tes­ti­nal hae­mor­rhage. The diag­no­sis, once the bleed­ing was con­trolled, was ­arrived at after CT-scan­ning and arter­i­og­ra­phy. A Dac­ron pros­the­sis was inter­posed into the descend­ing tho­rac­ic aorta to ­restore aor­tic flow; later an oesoph­a­gec­to­my plus oesoph­a­gos­to­my and jej­u­nos­to­my were car­ried out.

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