Lin Chen-Sheng, Tung Chun-Fang, Yeh Hong-Zen, Chang Chi-Sen, Lin Cheng-Wen
Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2008 Feb;71(2):100-2. doi: 10.1016/S1726-4901(08)70083-2.
Aortoesophageal fistula (AEF) is a rare but fatal cause of gastrointestinal hemorrhage, being most commonly associated with thoracic aortic aneurysm. We present a rare case of secondary AEF post graft treatment for mycotic aneurysm of thoracic aorta 4 years previously. Massive upper gastrointestinal hemorrhage resulted in difficult diagnosis by gastrointestinal endoscopy. Computed tomography angiography (CTA) showed contrast extravasation from the descending aorta into the mid-third esophagus. CTA is a useful diagnostic tool in patients suspected of having AEF. Rapid identification of AEF is important for definitive treatment and increases the likelihood of survival.
主动脉食管瘘（AEF）是胃肠道出血的一种罕见但致命的病因，最常与胸主动脉瘤相关。我们报告一例罕见病例，患者4年前因胸主动脉霉菌性动脉瘤接受移植治疗后发生继发性AEF。大量上消化道出血导致胃肠内镜检查难以诊断。计算机断层血管造影（CTA）显示造影剂从降主动脉外渗至食管中下段。CTA是怀疑患有AEF患者的一种有用诊断工具。快速识别AEF对于确定性治疗很重要，并可提高生存几率。
