Cause of mortality in aortoesophageal fistula: oesophageal sepsis. A case report

Aday, Ulaş; Çetin, Durmuş Ali; Çiyiltepe, Hüseyin; Gündeş, Ebubekir; Bozdağ, Emre; Senger, Aziz Serkan

doi:10.5114/pg.2017.70476

Cited by 5 publications

(7 citation statements)

References 14 publications

(25 reference statements)

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“…The management includes haemorrhage control and treatment of the diseased oesophagus. Most commonly the latter is in the form of a resection (with or without immediate reconstruction), primary fistula repair or oesophageal stenting [ 7–9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patient had further hematemesis, becoming hemodynamically unstable with a tachycardia of 140 bpm. His haemoglobin dropped to 127 g/L and white cell count was 35.7 (×10 7 /L).…”

Section: Casementioning

confidence: 97%

“…He was given intravenous tranexamic acid, vitamin K, pantoprazole, tazocin and 2 units of packed red blood cells (pRBCs). Blood tests showed a haemoglobin of 150 g/L, white cell count of 24 (×10 7 /L), platelets of 503 (×10 7 /L), lactate of 2.2 mmol/L and normal clotting, renal and liver function tests.…”

Section: Casementioning

confidence: 99%

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Dual-modality emergency management of a rare cause of an aorto-oesophageal fistula: a case report

Vasanthan

Tabbakh

Doran

et al. 2021

Journal of Surgical Case Reports

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Aorto-oesophageal fistula (AOF) is a life-threatening condition that usually presents with upper gastro-intestinal haemorrhage. This case report details the emergency presentation and management of a 51-year-old male who presented with hematemesis secondary to an impacted denture (ingested two years previously) in the oesophagus that had led to an AOF. This necessitated urgent thoracic endovascular aortic repair followed by thoracotomy, oesophagotomy, T-tube insertion and oesophagostomy. This is the first documentation in the literature of the dual-modality management for this rare cause of AOF and demonstrates the multidisciplinary approach to successful management of this complex yet rare presentation.

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Section: Discussionmentioning

confidence: 99%

“…The patient had further hematemesis, becoming hemodynamically unstable with a tachycardia of 140 bpm. His haemoglobin dropped to 127 g/L and white cell count was 35.7 (×10 7 /L).…”

Section: Casementioning

confidence: 97%

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Dual-modality emergency management of a rare cause of an aorto-oesophageal fistula: a case report

Vasanthan

Tabbakh

Doran

et al. 2021

Journal of Surgical Case Reports

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“…Endoscopic self-expanding esophageal stents are typically used for the palliation of malignant esophageal stricture; they can be helpful to control bleeding in esophageal fistula and prevent the entry of esophageal contents into the fistula [ 42 ]. An esophageal stent alone or combined with TEVAR could be a palliative option for patients who are unable to tolerate radical surgery [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…An esophageal stent alone or combined with TEVAR could be a palliative option for patients who are unable to tolerate radical surgery [ 43 , 44 ]. Although the longest reported poststent survival has been 8 months [ 42 ], the prognosis is typically unfavorable [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Mortality in Patients with Aortoesophageal Fistula Related to Aortic Lesions

Gao

et al. 2020

Gastroenterology Research and Practice

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Objective. Aortoesophageal fistula (AEF) related to aortic aneurysm and dissection is an uncommon but life-threatening condition. We performed a systematic review of risk factors for mortality and factors associated with the prognosis of AEF. Methods. A systematic search of the PubMed, Embase, and Cochrane Library databases was performed. Clinical characteristics, diagnostic methods, and treatments were assessed in terms of their ability to predict mortality. Results. The systematic review identified 184 eligible articles including 219 patients with AEF. Multivariable Cox regression revealed positive correlations of hemorrhagic shock (hazard ratio (HR): 1.824, 95% CI: 1.217-2.735, P=0.004), sepsis (HR: 1.714, 95% CI: 1.112-2.641, P=0.015), multiorgan failure (HR: 3.060, 95% CI: 1.470-6.368, P=0.003), and conservative treatment (HR: 5.257, 95% CI: 3.405-8.116, P<0.001) with mortality and a negative correlation between combination therapy (aortic graft replacement and esophagectomy) and mortality (HR: 0.319, 95% CI: 0.125-0.813, P=0.017). Kaplan–Meier survival analysis showed that the 1-year cumulative survival rate was 42.5±3.8%. The overall fistula-related mortality rate was 47.0% (103/219). The most common causes of death were bleeding (54.9%) and infection (29.2%). Conclusions. We found that hemorrhagic shock, sepsis, and multiorgan failure were risk factors for death in patients with AEF. Additionally, conservative treatment was associated with a higher rate of mortality, while combined aortic graft replacement and esophagectomy improved the prognosis.

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Aortoesophageal fistula: review of trends in the last decade

et al. 2019

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Cause of mortality in aortoesophageal fistula: oesophageal sepsis. A case report

Cited by 5 publications

References 14 publications

Dual-modality emergency management of a rare cause of an aorto-oesophageal fistula: a case report

Dual-modality emergency management of a rare cause of an aorto-oesophageal fistula: a case report

Risk Factors for Mortality in Patients with Aortoesophageal Fistula Related to Aortic Lesions

Aortoesophageal fistula: review of trends in the last decade

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