eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
Bieżący numer Archiwum Artykuły zaakceptowane O czasopiśmie Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac
NOWOŚĆ
Portal dla gastroenterologów!
www.egastroenterologia.pl
SCImago Journal & Country Rank
3/2017
vol. 12
 
Poleć ten artykuł:
Udostępnij:
więcej
 
 
streszczenie artykułu:
List do Redakcji

Cause of mortality in aortoesophageal fistula: oesophageal sepsis. A case report

Ulaş Aday, Durmuş Ali Çetin, Hüseyin Çiyiltepe, Ebubekir Gündeş, Emre Bozdağ, Aziz Serkan Senger

Data publikacji online: 2017/09/30
Pełna treść artykułu
Pobierz cytowanie
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Aortoesophageal fistula (AEF) is a rare condition, which causes massive upper gastrointestinal system bleeding [1]. The most frequent cause of primary AEF is thoracic aortic aneurysm, which is engendered by such causes as the rupture of penetrating aortic ulcer, foreign body swallowing, thoracic trauma, oesophageal cancer, and bronchogenic carcinoma. Secondary AEF, on the other hand, is frequently caused by surgical procedures done by graft because of aortic aneurysms or neighbouring organ surgeries [2, 3]. Emergency surgical procedures to treat life-threatening massive bleeding following AEF have a high risk of mortality. Therefore, thoracic endovascular aortic repair (TEVAR) has recently become a popular and effective method [4]. It has been reported that the most significant clinical condition affecting patients’ long-term survival following the achievement of bleeding control through TEVAR was continuing oesophageal fistula and the related sepsis secondary to mediastinitis. Thus, it has been suggested that definitive surgical procedures to treat the oesophagus should be performed without delay following the stabilisation of the patient [5]. The surgical procedure to be performed varies according to the underlying causes. The control of the continuing infection and the related sepsis has been considered to be the Achilles’ heel of treatment [6].
This study presents the case of a patient with AEF, whose bleeding control was achieved through TEVAR, but who died of oesophageal sepsis. The goal of the study is to underline the significance of the oesophagus in clinical profile and the control of the source of infection in order to decrease the rate of mortality.
A 59-year-old female patient had been evaluated at a different centre because of haematemesis, which had started three days earlier, and had been referred to our hospital’s cardiovascular surgery clinic diagnosed with AEF. The patient, who had a history of diabetes for about 25 years, had no history of surgery. The first clinical evaluation of the patient revealed arterial blood pressure level of 108/68 mm Hg, heart rate of 112 min–1, and a normal neurological examination result. Her rectal evaluation showed melena. The patient was taken into intensive care and was monitored. Her laboratory results were as follows: hematocrit 22.4% (normal range: 33–54%), hemoglobin 7.8 g/dl (normal range: 11.1–17.1 g/dl), urea 100 mg/dl (normal range: 10–50 mg/dl), albumin 1.87 g/dl...


Pełna treść artykułu...
referencje:
Reardon MJ, Brewer RJ, LeMaire SA, et al. Surgical management of primary aortoesphageal fistula secondary to thoracic aneurysm. Ann Thorac Surg 2000; 69: 967-70.
Topel I, Stehr A, Steinbauer MG, et al. Surgical strategy in aortoesophageal fistulae: endovascular stent grafts and in situ repair of the aorta with cryopreserved homografts. Ann Surg 2007; 246: 853-9.
Arab WA, Chagnon F, Echave V, Sirois M. A multidisciplinary approach to aortoesophageal fistula: a case report. Turkish J Thorac Cardiovasc Surg 2011; 19: 285-87.
Canaud L, Ozdemir BA, Bee WW, et al. Thoracic endovascular aortic repair in management of aortoesophageal fistulas. J Vasc Surg 2014; 59: 248-54.
Akashi H, Kawamoto S, Saiki Y, et al. Therapeutic strategy for treating aortoesophageal fistulas. Gen Thorac Cardiovasc Surg 2014; 62: 573-80.
Mosquera VX, Marini M, Pombo-Felipe F, et al. Predictors of outcome and different management of aortobronchial and aortoesophageal fistulas. J Thorac Cardiovasc Surg 2014; 148: 3020-6.
Barrios Carvajal M, Díaz-Tobarra M, Martí-Obiol R, et al. Combined treatment of an aortoesophageal fistula after aortoplasty for aortic stenosis. Ann Thorac Surg 2015; 100: 1091-3.
Dumfarth J, Dejaco H, Krapf C, et al. Aorto-esophageal fistula after thoracic endovascular aortic repair: successful open treatment. Aorta (Stamford) 2014; 2: 37-40.
Leenders BJ, Stronkhorst A, Smulders FJ, et al. Removable and reposition able covered metal self-expandable stents for leaks after upper gastrointestinal surgery: experiences in a tertiary referral hospital. Surg Endosc 2013; 27: 2751-9.
vanHeel NC, Haringsma J, Wijnhoven BP, Kuipers EJ. Endoscopic removal of self-expandable metal stents from the esophagus (with video). Gastrointest Endosc 2011; 74: 44-50.
Schweigert M, Dubecz A, Stadlhuber RJ, et al. Treatment of intrathoracic esophageal anastomotic leaks by means of endoscopic stent implantation. Interact Cardiovasc Thorac Surg 2011; 12: 147-51.
Marone EM, Coppi G, Kahlberg A, et al. Combined endovascular and surgical treatment of primary aortoesophageal fistula. Tex Heart Inst J 2010; 37: 722-4.
Malas MB, Saha S, Qazi U, et al. Is endovascular stent-graft treatment of primary aortoesophageal fistula worthwhile? Vasc Endovascular Surg 2011; 45: 83-9.
Göbölös L, Miskolczi S, Pousios D, et al. Management options for aorto-oesophageal fistula: case histories and review of the literature. Perfusion 2013; 28: 286-90.
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe