Xu Yongwei, Li Ran, Zhang Kangwei, Xu Shuchang
Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Preparatory Stage), Shanghai 200065, China.
Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
Diagnostics (Basel). 2022 Dec 23;13(1):40. doi: 10.3390/diagnostics13010040.
Aortoesophageal fistula (AEF) is a relatively rare and potentially fatal disease. Secondary AEF is rare but is associated with serious complications and high mortality. There are rare cases of esophageal mediastinal fistula after descending aortic aneurysm stent implantation. We report the case of a 76-year-old man who had upper abdominal distension, without obvious inducement, for 3 months and felt fullness after a meal, accompanied by anorexia. A chest computer tomography (CT) examination of the abdomen was performed with the outside hospital. Descending thoracic aortic aneurysm was discovered and was treated with stent implantation. The patient was transferred to our hospital to continue treatment, mainly because of an esophageal mediastinal fistula. Finally, the thoracic aortic aneurysm was diagnosed as AEF after stent implantation, combined with the diagnosis of upper gastrointestinal bleeding. We hope that, through this case, we can explain the possible causes of bronchial mediastinal fistula after stent implantation of descending aortic aneurysm and the mechanism of upper gastrointestinal bleeding.
主动脉食管瘘（AEF）是一种相对罕见且可能致命的疾病。继发性AEF较为罕见，但与严重并发症和高死亡率相关。降主动脉瘤支架植入术后发生食管纵隔瘘的病例罕见。我们报告一例76岁男性患者，无明显诱因出现上腹胀3个月，进食后有饱腹感，伴有厌食。在外院进行了胸部计算机断层扫描（CT）腹部检查。发现降胸主动脉瘤并进行了支架植入治疗。患者因食管纵隔瘘转至我院继续治疗。最终，该胸主动脉瘤在支架植入后被诊断为AEF，并合并上消化道出血诊断。我们希望通过这个病例，能够阐明降主动脉瘤支架植入术后支气管纵隔瘘的可能原因以及上消化道出血的机制。
