da Silva E S, Tozzi F L, Otochi J P, de Tolosa E M, Neves C R, Fortes F
Department of Surgery, São Paulo University School of Medicine, Brazil.
J Vasc Surg. 1999 Dec;30(6):1150-7. doi: 10.1016/s0741-5214(99)70056-x.
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.
动脉粥样硬化性胸主动脉瘤引起的主动脉食管瘘较为罕见，但通常是一种致命性疾病，鲜有存活病例报道。我们报告了一例72岁男性主动脉食管瘘患者，经两阶段手术成功治疗的病例。第一阶段，我们原位切除主动脉瘤并用人工血管置换，行食管切除术、颈部食管造口术和空肠造口术。患者术后恢复良好后，进行经纵隔胸骨后胃代食管术，在颈部区域行食管胃吻合术，以重建胃肠道。我们还讨论了病因、诊断方法、主动脉和食管的处理，并对文献进行了综述。
