Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb 7;19(1):70.
doi: 10.1186/s13019-024-02540-1.

A successful endovascular aortic repair of aortoesophageal fistula following esophagectomy: a case report and literature review

Jina Li  1   2 , Yan Hu  1 , Wenliang Liu  1 , Jingqun Tang  1 , Song Zhu  1   2 , Chao Zeng  3
Affiliations
Review

A successful endovascular aortic repair of aortoesophageal fistula following esophagectomy: a case report and literature review

Jina Li et al. J Cardiothorac Surg. .

Abstract

Background: Aortoesophageal fistula (AEF) is an extremely rare and highly fatal complication leading to a high risk of morbidity and mortality. Successful management of AEF after esophagectomy for esophageal carcinoma has rarely been reported in the literature.

Case presentation: Here we present a rare case of a 44-year-old female with complications of AEF after esophagectomy for esophageal carcinoma, mainly presented as vomiting of blood. Both computed tomographic and computed tomography angiography of the chest showed bilateral pleural effusion and atelectasis, while gastroscopy showed large gastrointestinal bleeding. Emergency surgery was performed that included the removal of the mediastinal abscess, left lower pulmonary wedge resection, and thoracic endovascular aortic repair (TEVAR), followed by supportive treatment. The surgery went successful, and the patient was followed up for 1 year after discharge and showed good recovery. We also reviewed previous literature on the history, causes, pathophysiology, clinical presentation, diagnosis, and treatment of AEF after esophagectomy for esophageal adenocarcinoma.

Conclusions: In our case, thoracotomy combined with TEVAR was effective in treating AEF after esophagectomy for esophageal adenocarcinoma. This case provides successful experiences for clinical diagnosis and treatment of AEF after esophagectomy for esophageal carcinoma.

Keywords: Aortoesophageal fistula; Esophageal carcinoma; Esophagectomy; Thoracic endovascular aortic repair.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare in this work.

Figures

Fig. 1
Fig. 1
Results of preoperative gastroscope and biopsy
Fig. 2
Fig. 2
Chest CT before the operation of esophageal carcinoma
Fig. 3
Fig. 3
CTA of the whole aorta on the 19th day
Fig. 4
Fig. 4
After exploratory thoracotomy and TEVAR (X-ray)
Fig. 5
Fig. 5
One-week after exploratory thoracotomy and TEVAR (Upper gastrointestinal radiography)
Fig. 6
Fig. 6
One-year after exploratory thoracotomy and TEVAR (Chest CT scan)
See this image and copyright information in PMC

References

    1. Hollander JE, Quick G. Aortoesophageal fistula: a comprehensive review of the literature. Am J Med. 1991;91:279–287. doi: 10.1016/0002-9343(91)90129-L. - DOI - PubMed
    1. Takeno S, Ishii H, Nanashima A, et al. Aortoesophageal fistula: review of trends in the last decade. Surg Today. 2020;50:1551–1559. doi: 10.1007/s00595-019-01937-z. - DOI - PubMed
    1. Danihel L, Sisovsky V, Mosna K, Schnorrer M. Aortoesophageal fistula: rare cause of gastrointestinal bleeding. J Emerg Med Trauma Surg Care. 2019;6:038. doi: 10.24966/ETS-8798/100038. - DOI
    1. Seal KS, Abu-Halimah SJ, Dyer BW, et al. Staged repair of primary aortoesophageal fistula. The American surgeon, 2023; 31348231173949 (Advance online publication) - PubMed
    1. Dubrueil Observations súr la perforation of l´oesophageet de l´aortaethoracique par une potion d´osavale: avec der reflexions. J UnivSci Med. 1818;9:357–363.