J Korean Soc Emerg Med.  2017 Oct;28(5):526-529. 10.0000/jksem.2017.28.5.526.

Primary Aortoesophageal Fistula Presented as Massive Upper Gastrointestinal Bleeding

Affiliations
  • 1Department of Emergency Medicine, Kangwon National University School of Medicine, Chuncheon, Korea. otgotg11@gmail.com
  • 2Department of Radiology, Kangwon National University Hospital, Chuncheon, Korea.
  • 3Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.

Abstract

An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.

Keyword

Aortic aneurysm; Thoracic; Esophageal fistula; Gastrointestinal hemorrhage

MeSH Terms

Aged, 80 and over
Aortic Aneurysm
Diagnosis
Emergencies
Esophageal Fistula
Fistula*
Gastrointestinal Hemorrhage
Hematemesis
Hemorrhage*
Humans
Syncope
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