Aorto-oesophageal fistula: an unusual complication of oesophageal biopsies

Wiggins, Tom; Chaudry, Muhammed Asif; Vasas, Péter; Bryant, Catherine; Hughes, Frances

doi:10.1136/bcr.01.2011.3770

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…Primary causes described include thoracic aortic aneurysm 1 and carcinoma of the oesophagus. 2 Secondary causes include foreign body ingestion 3 such as chicken and fish bones, surgical instrumentation, and procedures such as oesophageal biopsy, 4 and erosion from aortic bypass grafts. 5 In this case report, we describe a patient with AEF who presented with massive haematemesis from an oesophageal lesion found on endoscopy.…”

Section: Aorto-oesophageal Fistula From Miliary Tuberculosismentioning

confidence: 99%

Aorto-oesophageal Fistula from Miliary Tuberculosis: A Rare Cause of Massive Haematemesis

Yeow

Fong

Rao

et al. 2014

Ann Acad Med Singap

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Section: Aorto-oesophageal Fistula From Miliary Tuberculosismentioning

confidence: 99%

Aorto-oesophageal Fistula from Miliary Tuberculosis: A Rare Cause of Massive Haematemesis

Yeow

Fong

Rao

et al. 2014

Ann Acad Med Singap

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“…1), it rarely depicts the fistula itself, but it clearly shows some suggestive signs, such as the presence of air bubbles within the thrombus in the aorta or around the thickened esophageal/bronchial wall, persistent/expanding fluid collection around the graft, irregular density components of soft tissue more than 6 months after the TEVAR implantation, loss of the aortoesophageal fat plane, or the extravasation of contrast outside the aortic lumen [10,43]. High-resolution CT (HR-CT) provides a higher accuracy rate for AEF with its clear view of the mediastinum components, and, further, it can help to assess the condition of a pseudo-aneurysm or mediastinitis together with the extent of soft tissue involvement, so as to enable planning for aspiration or drainage of the inflamed components [44].…”

Section: Importance Of Early Diagnosis Of Post-tevar Aefmentioning

confidence: 99%

“…Further studies described other causes including esophageal reflux, tuberculosis, congenital abnormalities and traumatic injuries [2,[5][6][7]. Among traumatic injuries, the numbers of iatrogenic complications, such as failure of the sutures for esophagectomy, esophageal stent placement, nasogastric tube insertion, endoscopic esophageal biopsies and (chemo) radiation therapy for lung/esophageal cancer, have been increasing [2,[8][9][10][11][12][13]. Accordingly, the etiology of AEF has changed together with gradual improvements in diagnostic/treatment technologies.…”

Section: Etiologies Of Aorto-esophageal Fistulamentioning

confidence: 99%

Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature

Uno

Koike

Takahashi

et al. 2017

Clin J Gastroenterol

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Aorto-esophageal fistula (AEF) is a rare and lethal entity, and the difficulty of making diagnosis of AEF is well-known. As promising results in the short-term effectiveness of thoracic endovascular aortic repair (TEVAR) promote its usage, the occurrence of AEF after TEVAR (post-TEVAR AEF) increases as one of the major complications. Therefore, we provide a review concerning the management strategy of post-TEVAR AEF. Although its representative symptom was reported as the triad of mid-thoracic pain and sentinel hematemesis followed by massive hematemesis, the symptom-free interval between sentinel hemorrhage and massive exsanguination is unpredictable. However, the physiological condition represents a surgical contraindication. Accordingly, early diagnosis is important, but either CT or esophago-gastroduodenoscopy rarely depicts a typical image. The formation of post-TEVAR AEF might be associated with the infection of micro-organisms, which is uncontrollable with anti-biotic administration. The current first-line strategy is combination therapy as follows, (1) to control bleeding by TEVAR in the urgent phase, and (2) radical debridement and aortic/esophageal re-construction in the semi-urgent phase. In view of the high mortality and morbidity rate, it is proposed that the choice in treatment strategies might be affected by patient's condition, size of the wall defects and the etiology of AEF. Practically, we should keep in mind the importance of making an early diagnosis and, once a suspicious symptom has occurred in a patient with a history of TEVAR, the existence of post-TEVAR AEF should be suspected. A prospective registry together with more developed technologies will be needed to establish a future strategy.Keywords Aorto-esophageal fistula Á Thoracic endovascular aortic repair Á Thoracic aortic aneurysm Á Endoscopy Á Surgery Abbreviations

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Aorto-oesophageal fistula: an unusual complication of oesophageal biopsies

Cited by 2 publications

References 12 publications

Aorto-oesophageal Fistula from Miliary Tuberculosis: A Rare Cause of Massive Haematemesis

Aorto-oesophageal Fistula from Miliary Tuberculosis: A Rare Cause of Massive Haematemesis

Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature

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