Abstract
Oesophageal carcinoma remains one of the most common forms of cancer. Resection in the form of oesophagectomy and gastric interposition remains the standard surgical treatment and is associated with a high rate of post-operative morbidity. We report a case of a 71-year old male who underwent successful Ivor-Lewis oesophageal resection and developed life-threatening haemorrhage 2 weeks post-op, attributed to an arterial-oesophageal fistula. The patient was transferred to a specialist ENT centre with ligation of branches of the carotid artery, but intermittent bleeding continued. Following transfer to a specialist oesophago-gastric unit, repeated angiography was required to image the point of bleeding, which was embolised via percutaneous technique. The etiology, presentation, diagnosis and management of arterial-oesophageal fistulae are discussed, along with review of existing reports of similar complications and treatment options. A multidisciplinary approach, along with timely and often repeated imaging, is required in the management of arterial-oesophageal fistulae.
This is a preview of subscription content, log in via an institution to check access.
References
Dhungel B, Diggs B, Hunter J, Sheppard B, Vetto J, Dolan J (2010) Patient and peri-operative predictors of morbidity and mortality after esophagectomy: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2005–2008. J Gastrointest Surg 14:1492–1501
Di Mauro D, Sarli L, Roncoroni L (2009) An exceptional postoperative gastric tube bleeding after esophageal resection for cancer. Dis Esophagus 22:E11–E13
Behranwala K, Fullard M, Livingstone J (2010) Pharyngojejunal tubes for feeding after upper gastrointestinal surgery: the way forward. Ann Royal Coll Surg Eng 92(6):529
Katsoulis I, Livingstone J, Sagor G (2006) Tube pharyngostomy: a simple method for prolonged intubation of the foregute following oesophagogastric surgery. Dig Surg 23:292–295
Edge CJ, Langdon JD (1991) Complications of pharyngostomy. Br J Oral Maxillofac Surg 29:237–240
Pevow FM (1969) Complications of cervival esophagostomy. Arch Otolaryngol 90:171–172
Hollander JE, Quick G (1991) Aortoesophageal fistula: a comprehensive review of the literature. Am J Med 91:279–287
Millar A, Rostom A, Rasuli P, Saloojee N (2007) Upper gastrointestinal bleeding secondary to an aberrant right subclavian artery-esophageal fistula: a case report and review of the literature. Can J Gastroenterol 20(6):389–393
Feugier P, Lemoine L, Gruner L, Bertin-Maghit M, Rousselet B, Chevalier JM (2003) Arterioesophageal fistula: a rare complication of retroesophageal subclavian arteries. Ann Vasc Surg 17(3):302–305
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pucher, P., Kashef, E., Woods, C. et al. Life-threatening bleeding from arterial-oesophageal fistula following oesophagectomy. Updates Surg 65, 149–152 (2013). https://doi.org/10.1007/s13304-012-0136-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-012-0136-5