Joseph Kyle R, Singh Jyotindra, Chin Ronald, Lee Arvind, Oborska Yana, Mayorchak Yaroslav
Nepean Hospital, Australia.
Nepean Private Hospital, Australia.
Int J Surg Case Rep. 2024 Aug;121:110035. doi: 10.1016/j.ijscr.2024.110035. Epub 2024 Jul 14.
Acute aorto-oesophageal fistula poses a significant mortality risk, requiring immediate and decisive medical intervention. This report highlights the critical need for innovation in emergency surgical responses.
A 57-year-old male, with a history of aortic repair, presented with chronic anaemia and dysphagia. He suffered a cardiac arrest from massive hematemesis during surgery for an infected thoracic hematoma. Lacking a Stengsten-Blackmore tube, a 26Fr Foley catheter was used to control the bleeding. This measure stabilized the patient enough for a definitive endovascular repair with aortic stents, which successfully managed the bleeding.
The treatment objectives for this condition include initial control of oesophageal bleeding, followed by endovascular management to further control the bleeding, subsequently releasing the oesophageal control, and ultimately preventing infection through the administration of intravenous antibiotics.
This case illustrates the importance of adaptability and the use of unconventional methods in emergency situations, demonstrating that innovative solutions can be lifesaving in critical surgical emergencies.
急性主动脉-食管瘘具有很高的死亡风险，需要立即进行果断的医疗干预。本报告强调了紧急手术应对中创新的迫切需求。
一名57岁男性，有主动脉修复病史，出现慢性贫血和吞咽困难。他在因感染性胸部血肿进行手术期间因大量呕血发生心脏骤停。由于没有Stengsten-Blackmore管，使用了一根26Fr的Foley导管来控制出血。这一措施使患者稳定下来，足以进行主动脉支架的确定性血管内修复，成功控制了出血。
这种情况的治疗目标包括首先控制食管出血，然后进行血管内治疗以进一步控制出血，随后解除食管控制，最终通过静脉注射抗生素预防感染。
本病例说明了在紧急情况下适应性和使用非常规方法的重要性，表明创新解决方案在关键手术紧急情况中可以挽救生命。
