Unosawa Satoshi, Hata Mitsumasa, Sezai Akira, Niino Tetsuya, Yoda Masataka, Shimura Kazuma, Furukawa Nobuyuki, Minami Kazutomo
Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Ohyaguchi-Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
Surg Today. 2008;38(1):62-4. doi: 10.1007/s00595-007-3569-6. Epub 2007 Dec 24.
An aortoesophageal fistula is uncommon, but almost always fatal. We report a case of an aortoesophageal fistula that developed after stent dilation for an esophageal stricture caused by benign esophagitis. As soon as esophageal hemorrhaging was identified by endoscopy, the patient was transferred to the operating theater; however, the uncontrollable and massive bleeding resulted in pulseless shock. The digestive surgeon put side-clamps on the descending aorta and esophagus and transferred the patient to our hospital. We identified an aortoesophageal fistula, 3.0 mm in diameter, in the descending aorta, and performed a graft replacement of the descending aorta and esophagectomy. It was immediately evident that the edge of the stent had been sticking into the aortic wall, which had caused the fistula. To our knowledge, this is the first report of successful surgical treatment of an aortoesophageal fistula caused by esophageal stent dilatation.
主动脉食管瘘并不常见，但几乎总是致命的。我们报告一例因良性食管炎导致食管狭窄，在支架扩张术后发生主动脉食管瘘的病例。在内镜检查发现食管出血后，患者立即被送往手术室；然而，无法控制的大量出血导致了无脉性休克。消化外科医生对降主动脉和食管进行了侧钳夹，并将患者转至我院。我们在降主动脉发现了一个直径为3.0毫米的主动脉食管瘘，并进行了降主动脉移植置换术和食管切除术。很明显，支架边缘一直刺入主动脉壁，从而导致了瘘管的形成。据我们所知，这是首例成功手术治疗由食管支架扩张引起的主动脉食管瘘的报告。
