Lee Sangmin, Kim Yook, Kim Ki Bae
Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Radiology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Korean J Gastroenterol. 2022 Nov 25;80(5):229-232. doi: 10.4166/kjg.2022.085.
A 91-year-old woman who presented with melena and hypovolemic shock visited the emergency room. She received enteral nutrition by nasogastric tube in a bedridden state due to hip surgery. Gastroscopy initially suggested a simple ulcer that occurred after a nasogastric tube was placed for a long time, but the ulcer was deep, and the amount of instantaneous bleeding was considerable. Therefore, an aortoesophageal fistula was suspected. Angiography was performed instead of endoscopic hemostasis, followed by thoracic endovascular aortic repair (TEVAR). After the TEVAR procedure, the patient recovered without further gastrointestinal bleeding. Prompt judgment and communication between the endoscopist and the interventional physician are important for successful hemostasis in an aortoenteric fistula patient.
