Timely Endoscopic Recognition of Aortoesophageal Fistula With Successful Treatment

Brotherton, Tim; Numan, Laith; Alkaade, Samer

doi:10.14309/crj.0000000000001123

Cited by 1 publication

(1 citation statement)

References 17 publications

(20 reference statements)

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“…In all successful cases where massive upper gastroesophageal bleeding was stopped, an esophageal balloon [ 6 , 7 ] or a Sengstaken–Blakemore tube (SBT) [ 8–10 ] was utilized, and this allowed for the temporary stabilization and had bought time for exact CT diagnosis and surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Stop exsanguination by inflation: management of aorta-esophageal fistula bleeding

Pagano,

Fokin,

Parra

et al. 2024

Journal of Surgical Case Reports

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Aortoesophageal fistula is rare and typically presents itself to the emergency department as Chiari’s Triad of mid-thoracic pain, sentinel arterial hemorrhage, and exsanguination after a symptom-free interval. However, fatal bleeding may be the first and last presentation of an aortoesophageal fistula. When a patient experiences massive hematemesis without witnesses, EMS may assume that bleed is of a traumatic mechanism. We present a case of a 59-year-old male with no previous medical history who was transported to a trauma center unconscious and with massive bleeding of unknown origin. Computed tomography revealed a thoracic aortic aneurysm and an aortoesophageal fistula. Bleeding was not controlled and the patient expired. Trauma bay personnel should follow an algorithm which includes a prompt tamponade of the bleed using a Sengstaken–Blakemore tube or esophageal balloon paralleled by massive transfusion and obtaining an early computed tomography scan to manage patients with massive gastroesophageal bleeding until appropriate surgical interventions can be initiated.

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Section: Discussionmentioning

confidence: 99%