Korean J Med.  2015 Feb;88(2):182-186. 10.3904/kjm.2015.88.2.182.

A Case of Aortoesophageal Fistula due to Esophageal Cancer Treated with Endovascular Stent Grafting

• Yoon KH
• Jang JY
• Oh SJ
• Park YM
• Jung MH
• Kim J
• Chang YW

• KMID: 2269149
• DOI: http://doi.org/10.3904/kjm.2015.88.2.182

Abstract

Hemorrhage into the esophagus due to aortoesophageal communication is very rare but life-threatening with high morbidity and mortality. Because of this, most cases of aortoesophageal fistula are confirmed by autopsy. However, we report herein a case of a 62-year-old male with an aortoesophageal fistula who was successfully treated with endovascular stent-grafting. The patient had undergone esophageal stent insertion due to esophageal cancer and experienced hematemesis and hemodynamic shock due to an aortoesophageal fistula. Emergency endoscopy was unable to identify the source of the hemorrhage due to massive bleeding. Computed tomography of the chest revealed a focal pseudoaneurysm at the descending aorta and diffuse thinning of the esophageal wall, which were treated with endovascular stent-grafting. Although aortoesophageal fistulas are usually fatal, implantation of a covered stent into the esophagus may help prevent massive bleeding, providing valuable time to treat the patient.

Keyword

Stent, vascular; Fistula, aortoesophageal; Cancer, esophagus

MeSH Terms

Aneurysm, False
Aorta, Thoracic
Autopsy
Blood Vessel Prosthesis*
Emergencies
Endoscopy
Esophageal Neoplasms*
Esophagus
Fistula*
Hematemesis
Hemodynamics
Hemorrhage
Humans
Male
Middle Aged
Mortality
Shock
Stents
Thorax