Alrenga D P
Am J Gastroenterol. 1976 May;65(5):422-6.
Four cases of esophageal carcinoma complicated by fatal hemorrhage are reported. All four patients had recently completed radiation therapy. An aortoesophageal fistula was present in two cases; fibrinoid necrosis of the esophageal arteries was present in the other two. The esophageal tumor was localized in two cases and had disappeared in one case. In one patient it had metastasized widely. Ninety-nine other reports of esophageal cancer and fatal hemorrhage are reviewed from the literature. Aortoesophageal fistula was the cause of hemorrhage in 78 cases. Occlusion of the vasa vasorum by thrombosis, inflammation, neoplastic cells or radiation injury appears to be the cause of aortic necrosis and fistula formation. Prompt surgical approach, if possible, should be used to control hemorrhage, as the primary tumor may be localized to the esophagus only.
报告了4例食管癌并发致命性出血的病例。所有4例患者近期均完成了放射治疗。其中2例存在主动脉食管瘘；另外2例存在食管动脉的纤维蛋白样坏死。2例患者的食管肿瘤局限，1例患者的肿瘤消失。1例患者的肿瘤已广泛转移。从文献中回顾了另外99例食管癌和致命性出血的报告。78例出血的原因是主动脉食管瘘。血管滋养血管被血栓形成、炎症、肿瘤细胞或放射损伤阻塞似乎是主动脉坏死和瘘形成的原因。如果可能，应采用迅速的手术方法来控制出血，因为原发性肿瘤可能仅局限于食管。
