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Repair of aortoesophageal fistula due to a penetrating atherosclerotic ulcer of the descending thoracic aorta and literature review.

Chandrashekar G, Kumar VM, Kumar AK - J Cardiothorac Surg (2007)

Bottom Line: In view of the emergency nature of the entity and complexity of the procedure management of such a condition is not standardized.The immediate concern is to save the patient from life threatening exsanguinations.We present a case of rupture of a penetrating atherosclerotic ulcer of descending thoracic aorta, where in an emergency surgery was performed and the patient is doing well 21 months later.

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Affiliation: Department of Cardiothoracic Surgery, Mallya Hospital, Bangalore 560001, India. drg.chandrashekar@gmail.com

ABSTRACT
Penetrating atherosclerotic ulcer rupturing into the esophagus is rare and the resulting aortoesophageal fistula carries a high mortality. In view of the emergency nature of the entity and complexity of the procedure management of such a condition is not standardized. The immediate concern is to save the patient from life threatening exsanguinations. Contrary to the practice hitherto followed no active surgical intervention was carried out for the esophageal lesion and cardiopulmonary bypass support was not employed. We present a case of rupture of a penetrating atherosclerotic ulcer of descending thoracic aorta, where in an emergency surgery was performed and the patient is doing well 21 months later.

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Contrast enhanced CT scan showing aortoesophageal fistula.
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Figure 1: Contrast enhanced CT scan showing aortoesophageal fistula.

Mentions: Contrast enhanced chest CT images acquired at thoracic region showed a penetrating aortic ulcer into the thoracic esophagus and focal anterior aortic defect with pseudo aneurysm formation [Fig 1, 2, 3]. There was no pleural effusion. A diagnosis of aortoesophageal fistula due to penetrating aortic ulcer was made and the patient taken up for an emergency surgery.


Repair of aortoesophageal fistula due to a penetrating atherosclerotic ulcer of the descending thoracic aorta and literature review.

Chandrashekar G, Kumar VM, Kumar AK - J Cardiothorac Surg (2007)

Contrast enhanced CT scan showing aortoesophageal fistula.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1803784&req=5

Figure 1: Contrast enhanced CT scan showing aortoesophageal fistula.
Mentions: Contrast enhanced chest CT images acquired at thoracic region showed a penetrating aortic ulcer into the thoracic esophagus and focal anterior aortic defect with pseudo aneurysm formation [Fig 1, 2, 3]. There was no pleural effusion. A diagnosis of aortoesophageal fistula due to penetrating aortic ulcer was made and the patient taken up for an emergency surgery.

Bottom Line: In view of the emergency nature of the entity and complexity of the procedure management of such a condition is not standardized.The immediate concern is to save the patient from life threatening exsanguinations.We present a case of rupture of a penetrating atherosclerotic ulcer of descending thoracic aorta, where in an emergency surgery was performed and the patient is doing well 21 months later.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiothoracic Surgery, Mallya Hospital, Bangalore 560001, India. drg.chandrashekar@gmail.com

ABSTRACT
Penetrating atherosclerotic ulcer rupturing into the esophagus is rare and the resulting aortoesophageal fistula carries a high mortality. In view of the emergency nature of the entity and complexity of the procedure management of such a condition is not standardized. The immediate concern is to save the patient from life threatening exsanguinations. Contrary to the practice hitherto followed no active surgical intervention was carried out for the esophageal lesion and cardiopulmonary bypass support was not employed. We present a case of rupture of a penetrating atherosclerotic ulcer of descending thoracic aorta, where in an emergency surgery was performed and the patient is doing well 21 months later.

Show MeSH
Related in: MedlinePlus