Pahwa Siddharth, Bhattacharya Susmit, Mukhopadhyay Siddhartha, Verma Ashok
Department of Cardiovascular Surgery, Mayo Clinic, 200 1st Street, Rochester, MN 55905, USA.
Department of Cardiovascular Surgery, AMRI Hospitals, 16 and 17 JC Block, Bidhannagar, Salt Lake, Kolkata 700098, West Bengal, India.
J Surg Case Rep. 2020 Jun 17;2020(6):rjaa114. doi: 10.1093/jscr/rjaa114. eCollection 2020 Jun.
An aorto-esophageal fistula (AEF) is a rare yet life-threatening cause of upper gastrointestinal bleeding. We report our experience with open surgical management of two cases of AEF. Both cases presented with almost identical presentations: hematemesis and hemodynamic instability. The aorta in the first patient was normal; the defect was small and was repaired with a Dacron patch. The second patient had an aneurysmal aorta, which was replaced with a Dacron graft. Both cases were performed under partial bypass. The esophageal rent in both patients was debrided, primarily closed and buttressed with a vascularized intercostal pedicle. Nonavailability of endovascular personnel and equipment along with hemodynamic instability of the patient influenced our surgical strategy. Long-term follow-up of these patients is necessary to analyze the outcomes of our surgical repair.
主动脉食管瘘（AEF）是上消化道出血的一种罕见但危及生命的病因。我们报告两例AEF患者的开放手术治疗经验。两例患者的表现几乎相同：呕血和血流动力学不稳定。首例患者的主动脉正常；缺损较小，用涤纶补片修复。第二例患者有主动脉瘤，用涤纶人工血管进行了置换。两例手术均在部分体外循环下进行。两位患者的食管裂口均进行了清创、一期缝合，并采用带血管蒂肋间肌瓣加固。血管腔内治疗人员和设备的缺乏以及患者的血流动力学不稳定影响了我们的手术策略。对这些患者进行长期随访对于分析我们手术修复的效果很有必要。
