Successful Third Surgery in Management of an Aortoesophageal Fistula due to a Thoracic Aortic Aneurysm / 日本心臓血管外科学会雑誌

ABSTRACT

A 70-year-old man presented at a nearby hospital with dysphagia, hematemesis, and hemorrhage. After examination by magnetic resonance imaging and gastrointestinal fiberscopy, he was referred to our hospital on the suspicion of an aortoesophageal fistula due to a thoracic aortic aneurysm. Considering the degree of invasion and infection, we planned two operations but were compelled to perform three operations because of esophageal leakage. Aortoesophageal fistula due to thoracic aneurysms are usually fatal, with only 18 reported survivors in the past 22 years. The optimal treatment for this condition is not yet known. We report survival of the first case of aortoesophageal fistula due to thoracic aneurysm complicated by mediastinitis caused by esophageal leakage in which management by two operations was initially planned. From this case many possible strategies to manage aortoesophageal fistula due to thoracic aneurysms arose. Therefore, we report this case together with a review of the literature.