Aortic aneurysm eroding the esophagus case report and review

Abstract

A 71-year-old woman developed dysphagia and hematemesis with an endoscopic diagnosis of esophageal submucosal hematoma. Post mortem examination demonstrated an aorto-esophageal fistula as the etiology of her hematemesis. The differential diagnosis of upper gastrointestinal bleeding in the elderly patient without cirrhosis is discussed. A review of the literature on aorto-esophageal fistula is included.

Dissecting Thoracic Aortic Aneurysm Perforating the Oesophagus and Masquerading as Peptic Ulcer Disease

“…Schramek et al (1971) and Sinar et al (1977) report that haemorrhage may be slow or even intermittent over weeks to months. This patient presented with symptomatology and signs compatible with aortic rupture into the oesophagus at least 4 weeks prior to his final episode.…”

Aortoesophageal fistula: A rare and dreaded cause of gastrointestinal haemorrhage

“…A barium swallow examination might show the thoracic aortic aneurysm as an extrinsic impression and deviation 2,7,48 . The deviation is usually anterior and to the right as most AEF arise from a TAA of descending thoracic aorta.…”

“…Aortoesophageal fistula (AEF) is an uncommon cause of gastrointestinal haemorrhage 1 . It results from an abnormal communication between the aorta and the oesophagus and constitutes less than 10% of all aorto‐enteric communications 2–4 . Most aortoesophageal fistula are diagnosed post‐mortem after a massive exsanguinating haemorrhage 5,6 .…”

Successful Endovascular Stent-Graft Treatment for an Aortoesophageal Fistula Caused by a Descending Thoracic Aortic Aneurysm: Report of a Case

“…9,10 The causes of AEF include rupture of a true or false thoracic aortic aneurysm, malignant mediastinal tumors, foreign bodies, inflammatory diseases, esophageal ulceration, and aortic arch anomalies, but rupture of a thoracic aortic aneurysm seems to be the most common cause. [11][12][13][14] Unfortunately, the diagnosis is rarely made before death, 9,[15][16][17] and when it is, even surgical management is largely unsuccessful. 17 Conventional surgical management involves excision or exclusion of the aneurysm combined with extra-anatomic bypass or in situ aneurysm repair.…”