Dunphy Kaitlyn M, Ulloa Jesus G, Benharash Peyman, Lee Jay, Baril Donald T
Department of Vascular Surgery, MedStar Washington Hospital Center/MedStar Georgetown University Hospital, Washington, D.C.
Division of Vascular Surgery, University of California, Los Angeles, Los Angeles, Calif.
J Vasc Surg Cases Innov Tech. 2020 Jun 30;6(3):313-316. doi: 10.1016/j.jvscit.2019.11.008. eCollection 2020 Sep.
Aortoesophageal fistula (AEF) is a rare complication of esophageal interventions. We present a 49-year-old woman who underwent Roux-en-Y gastric bypass with a recurrent gastrojejunal anastomotic leak requiring covered esophageal stent placement. She presented 1 month later with abdominal pain, leukocytosis, and hematemesis. A computed tomography scan demonstrated migration of the esophageal stent with aortic erosion concerning for AEF. She underwent emergent endovascular exclusion of an AEF to the descending thoracic aorta with subsequent esophageal resection and diversion and aortic endograft explant, resection, and homograft repair on postoperative day 6 allowing for staged removal of prosthetic material and maintenance of inline flow.
主动脉食管瘘（AEF）是食管介入治疗的一种罕见并发症。我们报告一名49岁女性，她接受了Roux-en-Y胃旁路手术，术后出现复发性胃空肠吻合口漏，需要放置带覆膜的食管支架。1个月后，她出现腹痛、白细胞增多和呕血。计算机断层扫描显示食管支架移位并伴有主动脉侵蚀，高度怀疑为AEF。她接受了紧急血管内治疗，对降主动脉的AEF进行封堵，随后在术后第6天进行了食管切除、改道以及主动脉移植物取出、切除和同种异体移植修复，以便分期取出假体材料并维持直线血流。
