Colleoni Neto R, Figueira A, Belassai E, Jorge Júnior M E, Del Grande J C, Cardoso S H, Haddad C M
Disciplina de Gastroenterologia Cirúrgica do Departamento de Cirurgiae, Universidade Federal de São Paulo, Escola Paulista de Medicina.
Rev Assoc Med Bras (1992). 1998 Apr-Jun;44(2):149-51. doi: 10.1590/s0104-42301998000200015.
Bleeding from an arterio-esophageal fistula is a rare and nearly lethal condition and surgical treatment is the only curative option. We report a case of bleeding from a fistula from an aberrant right subclavian artery to the esophagus. Diagnosis was made only at necropsy, despite of three previous laparotomies. This anatomical variation is found in 0.5% of the general population. Development of a communication between this artery and the esophagus, secondary to aneurysmatic dilatation or to prolonged nasogastric intubation, as probably occurred with this patient, is a extremely rare condition. Surgical treatment depends on the early recognition of clinical signs of the arterio-esophageal communication, before the onset of systemic complications of hypovolemic shock.
动脉-食管瘘出血是一种罕见且几乎致命的疾病，手术治疗是唯一的治愈选择。我们报告一例异常右锁骨下动脉至食管的瘘管出血病例。尽管此前进行了三次剖腹手术，但仅在尸检时才做出诊断。这种解剖变异在普通人群中的发生率为0.5%。该动脉与食管之间因动脉瘤样扩张或长期鼻胃管插管（该患者可能发生这种情况）而形成交通是一种极其罕见的情况。手术治疗取决于在低血容量性休克的全身并发症发生之前，尽早识别动脉-食管交通的临床体征。
