1/69. Two cases of aorto-gastrointestinal fistula.We report two cases of aorto-gastrointestinal fistula. Case 1, a 60-year-old man, suffered from repeat hematemesis. He was preoperatively diagnosed as aortoesophageal fistula with thoracic aortic aneurysm and was successfully treated by graft replacement of the aneurysm. Case 2, a 73-year-old man, presented with massive gastrointestinal bleeding, yet repeat endoscopical examination did not reveal the origin of the bleeding. He died of catastrophic hematochezia. The pathological findings at autopsy revealed an aortoduodenal fistula. These two cases suggested the importance to consider an aorto-gastrointestinal fistula in the differential diagnosis of patients presenting gastrointestinal hemorrhage.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/69. Combined resection of the thoracic esophagus and thoracic descending aorta.We conducted combined resection of the thoracic esophagus and thoracic descending aorta in 2 patients, one with advanced esophageal cancer with aortic invasion and the other aortoesophageal fistula caused by a false aortic aneurysm. Combined resection of esophageal tumor and adjacent involved organs was conducted in 14 patients with A3:T4 esophageal cancer but none survived 3 years and resecting tumor-invaded organs did not improve patient survival. One major problem of combined resection of the esophagus and aorta is contamination of the posterior mediastinum. In 1 patient, 2-stage surgery for the esophagus and in situ aortic replacement was conducted to reduce operative risk and avoiding infection of the prosthetic vascular graft. With thoracic descending aortic aneurysm adjacent to the esophagus on the increase, cardiovascular surgeons should prepared to undertake combined resection of both the aorta and esophagus.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
3/69. Aortoesophageal fistula caused by aneurysm of the thoracic aorta: successful surgical treatment, case report, and literature review.Aortoesophageal fistula induced by atherosclerotic thoracic aortic aneurysm is rare, but is usually a fatal disorder, with few survivors reported. We report the case of a 72-year-old man with aortoesophageal fistula successfully treated in a two-stage operation. In the first stage, we performed resection and replacement of the aortic aneurysm with a prosthetic graft in situ, esophagectomy, cervical esophagostomy, and jejunostomy. After the patient recovered well postoperatively, a transmediastinal retrosternal interposition of the stomach was performed, with esophagogastroanastomosis in the cervical area, to re-establish the gastrointestinal tract. We include a discussion of the causes, diagnostic approach, management of the aorta and esophagus, and review of the literature.- - - - - - - - - - ranking = 3keywords = aneurysm (Clic here for more details about this article) |
4/69. subclavian artery aneurysm with oesophagoarterial fistula.Aneurysms of the subclavian artery are rare. fistula formation between the subclavian artery and the oesophagus has been described in aberrant subclavian artery and oesophageal foreign body. However, a fistula between a non-aberrant subclavian artery aneurysm and the oesophagus has not been previously reported. In this report, an unusual case of subclavian artery aneurysm with a fistula to the oesophagus causing intractable haematemesis is presented with the angiographic findings.- - - - - - - - - - ranking = 3keywords = aneurysm (Clic here for more details about this article) |
5/69. Surgical management of primary aortoesophageal fistula secondary to thoracic aneurysm.Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncommon cause of gastrointestinal bleeding that is uniformly fatal without surgical intervention. These may be primary fistulas, in cases of thoracic aortic aneurysm without previous repair, or secondary fistulas occurring after surgical repair of thoracic aortic aneurysm. Surgical treatment has been successful in a small number of cases of primary aortoesophageal fistula, secondary to thoracic aortic aneurysm, but techniques used have varied. We report a successful repair of primary aortoesophageal fistula, secondary to descending thoracic aortic aneurysm, and review the evolution of management since the three previously reported successful repairs at our institution.- - - - - - - - - - ranking = 4.5keywords = aneurysm (Clic here for more details about this article) |
6/69. Aortoesophageal fistula caused by foreign body.Aortoesophageal fistula is rare. A woman who developed aortoesophageal fistula after swallowing a fish bone developed hematemesis. 7 days later, we resected a false aneurysm near the left subclavian artery and repaired this section twice. Despite these measures, the woman died on hospital day 21. The clinical diagnosis was massive hematemesis from an infected aortic wall. The method of diagnosis, control of infection, and operative repair of aortoesophageal fistula are discussed.- - - - - - - - - - ranking = 0.5keywords = aneurysm (Clic here for more details about this article) |
7/69. Primary aortoesophageal fistula: presenting as massive upper gastrointestinal hemorrhage.Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.- - - - - - - - - - ranking = 0.5keywords = aneurysm (Clic here for more details about this article) |
8/69. Extra-anatomic bypass grafting for aortoesophageal fistula: a logical operation.Aortoesophageal fistula (AEF) is an uncommon cause of upper gastrointestinal hemorrhage. Usually, but not always, patients present with a small sentinel bleed followed by a variable interval of apparent resolution, and then they experience a massive exsanguinating hemorrhage. The variable interval of time after the sentinel bleed is the period in which most AEFs resulting from thoracic aortic aneurysm have been successfully treated. Although only a few successful cases have been reported in the literature, most describe an in situ repair. We describe treatment of a late-presenting AEF due to a thoracic aneurysm with an extra-anatomic bypass graft for the aortic repair.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
9/69. Successful management of an aneurysmal aortoesophageal fistula.We report a case of aortoesophgeal fistula secondary to the aneurysm of the descending thoracic aorta. The patient presented with massive hematemesis with bright red blood. Patient was operated upon emergently and survived without complication. Six other such cases with successful outcome have been reported before, which depends on the prompt diagnosis and early surgical intervention.- - - - - - - - - - ranking = 2.5keywords = aneurysm (Clic here for more details about this article) |
10/69. Primary aorto-oesophageal fistula due to oesophageal carcinoma. Report of a successfully managed case.Aorto-oesophageal fistula is a rare but often fatal entity causing upper gastrointestinal bleeding. Amongst the different aetiologies described, the commonest is rupture of a thoracic aortic aneurysm into the oesophagus. This entity was first reported in 1818, and only recently have successfully treated cases been published. Other causes such as postoperative complications, tuberculosis and trauma are less common. Oesophageal malignancy perforating the aorta is a rarity. The authors describe a case of aortic perforation secondary to an oesophageal carcinoma, treated with initial success. The clinical onset was a massive upper gastrointestinal haemorrhage. The diagnosis, once the bleeding was controlled, was arrived at after CT-scanning and arteriography. A Dacron prosthesis was interposed into the descending thoracic aorta to restore aortic flow; later an oesophagectomy plus oesophagostomy and jejunostomy were carried out.- - - - - - - - - - ranking = 0.5keywords = aneurysm (Clic here for more details about this article) |
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