Esophagus

, Volume 8, Issue 4, pp 277–281 | Cite as

Intractable esophago-mediastinal fistula as a rare complication following thoracoabdominal aortic replacement

  • Takeyuki Wada
  • Hiroya Takeuchi
  • Naoki Fujimura
  • Rieko Nakamura
  • Takashi Oyama
  • Tsunehiro Takahashi
  • Norihito Wada
  • Yoshiro Saikawa
  • Hideyuki Shimizu
  • Ryohei Yozu
  • Yuko Kitagawa
Case Report

Abstract

Although occurring infrequently, esophago-mediastinal fistula is potentially life-threatening. We report a rare case of intractable esophago-mediastinal fistula following thoracoabdominal aortic replacement. A 62-year-old male patient with aortic dissection underwent thoracoabdominal aortic replacement. He suddenly developed septic shock with esophageal perforation on the 6th postoperative day. Conservative therapy was employed, and he was discharged from the hospital. However, he suffered another attack of septic shock resulting from an esophago-mediastinal fistula. Gastrointestinal endoscopy revealed a suture thread beside an esophageal fistula. The patient consequently underwent esophagectomy. After removal of the esophagus, we found a suture thread with pledgets in the mediastinum and removed it. He recovered successfully thereafter. Esophago-mediastinal fistula associated with pledgets is a rare complication of thoracoabdominal aortic replacement. We believe that radical surgery can be an effective treatment. A review of the current literature did not reveal any similar cases. In this report, we discuss the clinical course of such a rare case.

Keywords

Esophageal fistula Aortic aneurysm Esophagectomy 

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Copyright information

© The Japan Esophageal Society and Springer 2011

Authors and Affiliations

  • Takeyuki Wada
    • 1
  • Hiroya Takeuchi
    • 1
  • Naoki Fujimura
    • 1
  • Rieko Nakamura
    • 1
  • Takashi Oyama
    • 1
  • Tsunehiro Takahashi
    • 1
  • Norihito Wada
    • 1
  • Yoshiro Saikawa
    • 1
  • Hideyuki Shimizu
    • 2
  • Ryohei Yozu
    • 2
  • Yuko Kitagawa
    • 1
  1. 1.Division of General and Gastrointestinal Surgery, Department of Surgery, School of MedicineKeio UniversityTokyoJapan
  2. 2.Division of Cardiovascular Surgery, Department of Surgery, School of MedicineKeio UniversityTokyoJapan

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