A Case of Endovascular Stent Grafting for an Aortoesophageal Fistula / 대한내과학회지

ABSTRACT

An aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. The standard treatment of an aortoesophageal fistula is surgical, because conservative management results in very high mortality. Nevertheless, the mortality related to the surgical treatment ranges from 30 to 60%. Recently, endovascular stent grafting has become an alternative to open surgery in selected patients. We report an aortoesophageal fistula treated with endovascular stent grafting in an 84-year-old female with hematemesis and abdominal pain. Endoscopy showed a 5-cm pulsating esophageal mass with central ulceration and bleeding. Computed tomography (CT) of the abdomen revealed a descending thoracic aortic pseudoaneurysm. Being at high risk in open thoracic surgery, she underwent endovascular stenting. We suggest that endovascular stent grafting is an alternative treatment of aortoesophageal fistula, instead of open surgery, in selected patients.