A case of an aortoesophageal fistula presenting as a Dieulafoy-like lesion.
- Author:
Dae Jin KIM
1
;
Yun Jin CHUNG
;
Ju Young LEE
;
Wan Suk LEE
;
Hyun Chaol LEE
;
Min Kyu JUNG
;
Seong Woo JEON
Author Information
1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. sw-jeon@hanmail.net
- Publication Type:Case Report
- Keywords:
Hematemesis;
Aortoesophageal fistula
- MeSH:
Aged;
Angiography;
Aorta;
Aorta, Thoracic;
Emergencies;
Endoscopy;
Esophagus;
Female;
Fistula*;
Hematemesis;
Humans;
Necrosis;
Odors;
Thorax;
Tomography, X-Ray Computed;
Ulcer
- From:Korean Journal of Medicine
2007;73(5):539-543
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 68-year-old woman visited our emergency center because of hematemesis. An emergency endoscopy showed an exposed vessel with blood flowing into the upper esophagus. Angiography revealed the presence of extravasation of contrast at the level of the aortic arch and a tortuous fistula between the aortic arch and esophagus. Chest computerized tomography demonstrated the presence of an aortoesophageal fistula and air bubbles inside the fistula. The patient had emergency surgery and the intraoperative findings revealed an aortoesophageal fistula and necrotic materials with a foul odor at the upper esophagus. Primary closure and wrapping of the aorta were performed, but primary closure of the esophagus was impossible because of necrosis. An aortoesophageal fistula is a rare but life-threatening disease. As shown for this patient, an exposed vessel without ulceration at the upper esophagus should raise suspicion of an aortoesophageal fistula and a CT scan or angiography should be performed before endoscopic intervention.
