Successful treatment of bleeding from aortoesophageal fistula with a metallic self-expandable stent

Czech version

Authors: E. Evinová ¹; O. Urban ²; D. Kučera ³; P. Fojtík ¹; J. Krátký ⁴; T. Málek ⁵; Přemysl Falt ¹
Authors‘ workplace: Centrum péče o zažívací trakt, Vítkovická nemocnice a. s., Ostrava ¹; II. interní klinika – gastroenterologie a geriatrie LF UP a FN Olomouc ²; Vaskulární centrum, Vítkovická nemocnice a. s., Ostrava ³; Radiologické oddělení, Vítkovická nemocnice a. s., Ostrava ⁴; Anesteziologicko-resuscitační oddělení, Vítkovická nemocnice a. s., Ostrava ⁵
Published in: Gastroent Hepatol 2018; 72(3): 217-220
Category:
doi: https://doi.org/10.14735/amgh2018217

Overview

We present a case of a 70-year-old patient diagnosed with acute bleeding from an aortoesophageal fistula, which was treated by endoscopic insertion of a self-expandable stent. Although the haemostasis was successful, the patient died from complications. Aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding with high mortality and morbidity. Thoracic aortic aneurysm is the most common aetiology among other causes such as oesophageal carcinoma, foreign body ingestion, trauma or iatrogenic causes. It is an urgent condition that has often lethal consequences, especially due to a symptoms-free period followed by a massive haemorrhage. Nowadays, the diagnostic standard is computed tomography with angiography. The therapeutic solution consists in either a one-step (surgery) or two-step approach (endovascular treatment). However, the mortality from of aortoesophageal fistula is still high and requires multidisciplinary team collaboration to ensure a well-chosen therapeutic approach, and management of septic complications.

Key words:
aortoesophageal fistula – endoscopy – self-expandable metallic stent – gastrointestinal bleeding

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted: 13. 3. 2018

Accepted: 4. 6. 2018

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