An uncommon cause of hemoptysis: aortobronchial fistula

Fontana, Matteo; Tonelli, Roberto; Gozzi, Filippo; Castaniere, Ivana; Marchioni, Alessandro; Fantini, Riccardo; Coppi, Francesca; Natali, Filippo; Rovatti, E.; Clini, Enrico

doi:10.1186/s40248-018-0146-3

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Endovascular aortic repair (EVAR) can be used as a bridge approach in hemodynamically unstable patients [ 12 ]. The mortality rate in untreated cases is around 80-100%, while ranges from 30% to 56% in treated cases [ 8 , 13 , 14 ]. Our patient rapidly deteriorated and died shortly after EVAR.…”

Section: Discussionmentioning

confidence: 99%

It Is Not Always Diverticular Bleeding: Fatal Subtle Primary Aorto-Duodenal Fistula Associated With Abdominal Aortic Aneurysm

Jaber¹,

Alsakarneh²,

Sanders³

et al. 2023

Cureus

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Primary aorto-duodenal fistula (PADF) is a connection between the aorta and duodenum without prior aortic surgery. We present a case of an 80-year-old female who presented with hematochezia. She was vitally stable but later developed a large episode of hematemesis followed by cardiac arrest. A computed tomography angiogram (CTA) chest scan showed an abdominal aortic aneurysm (AAA) with no leakage or rupture. Esophagogastroduodenoscopy (EGD) demonstrated blood in the stomach and duodenum, but no source was identified. Tagged RBC scan showed massive hemorrhage in the stomach and proximal small bowel. Further review of the CT images identified a subtle PADF. The patient underwent endovascular aneurysm repair but died shortly after. Physicians should maintain a high awareness of PADF, particularly in elderly patients with obscure gastrointestinal bleeding with or without known AAA. Herald bleeding in the setting of an aortic aneurysm should raise suspicion for PADF even in the absence of extravasation on CTA.

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Section: Discussionmentioning

confidence: 99%

It Is Not Always Diverticular Bleeding: Fatal Subtle Primary Aorto-Duodenal Fistula Associated With Abdominal Aortic Aneurysm

Jaber¹,

Alsakarneh²,

Sanders³

et al. 2023

Cureus

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“…An ABF is a rare and potentially fatal condition if left untreated [ 6 , 10 ], most being caused by descending thoracic aorta PSAs eroding the trachea or a bronchus, thus leading to hemoptysis as the main symptom. The condition is frequently misdiagnosed especially in patients with comorbid conditions (our patient with SARS-CoV-2 pneumonia was initially suspected of pulmonary thromboembolism) and approximately 30% of cases are only confirmed at autopsy [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Hybrid Management of an Aortobronchial Fistula after Patch Aortoplasty for Aortic Coarctation in a Patient with SARS-CoV-2 Pneumonia: Case Report and Review of the Literature

et al. 2022

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Aortobronchial fistula is a rare cause of repeated hemoptysis and a potentially fatal condition if left untreated. We present the case of a 40-year-old man with repeated hemoptysis, excessive cough, and epistaxis ongoing for several days after SARS-CoV-2 pneumonia diagnosis. The patient had a history of patch aortoplasty for aortic coarctation and aortic valve replacement with a mechanical valve for aortic insufficiency due to bicuspid aortic valve at the age of 24. Computed tomography scan performed at presentation revealed a severely dilated ascending aorta, a thoracic aorta pseudoaneurysm at the site of the former coarctation, an aortobronchial fistula suggested by the thickened left lower lobe apical segmental bronchus in contact with the pseudoaneurysm and signs of alveolar hemorrhage in the respective segment. The patient was treated with thoracic endovascular aneurysm repair (TEVAR) after prior hemi-aortic arch debranching and transposition of the left common carotid artery and subclavian artery through a closed-chest surgical approach. Our case report together with a systematic review of the literature highlight the importance of both considering an aortobronchial fistula in the differential diagnosis of hemoptysis in patients with prior history of thoracic aorta surgical intervention, regardless of associated pathology, and of taking into account endovascular and hybrid techniques as an alternative to open surgical repair, which carries a high risk of morbidity and mortality.

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“…2,5,6 Similar conditions have been described with connections to the bronchial tree (aortobronchial fistula), aorto-cardiac fistulas, and aorta-venous (aortocaval) fistulas. [6][7][8][9] Further AEF/ADF can be classified into primary fistulas, developing de novo from direct communication between an AAA and the GIT, and secondary, where the communication between the aorta and GIT develops on the background of previous aortic reconstruction surgery. 1 The incidence of AEF remains low, with secondary AEF occurring much more commonly, with an incidence of 0.36-1.6% of patients undergoing aortic reconstructive surgery, who can develop the condition even years after the surgery.…”

Section: Introductionmentioning

confidence: 99%

Primary aortoduodenal fistula: a rare cause of massive gastrointestinal hemorrhage

2021

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An uncommon cause of hemoptysis: aortobronchial fistula

Cited by 7 publications

References 13 publications

It Is Not Always Diverticular Bleeding: Fatal Subtle Primary Aorto-Duodenal Fistula Associated With Abdominal Aortic Aneurysm

It Is Not Always Diverticular Bleeding: Fatal Subtle Primary Aorto-Duodenal Fistula Associated With Abdominal Aortic Aneurysm

Hybrid Management of an Aortobronchial Fistula after Patch Aortoplasty for Aortic Coarctation in a Patient with SARS-CoV-2 Pneumonia: Case Report and Review of the Literature

Primary aortoduodenal fistula: a rare cause of massive gastrointestinal hemorrhage

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