Skip to main content
SpringerLink
Log in

Endoscopic Diagnosis of a Clinically Silent Aortoesophageal Fistula: Case Report and Review of the Literature

  • Case Reports
  • Published:
Annals of Vascular Surgery

Abstract

We report a rare case of a secondary aortoesophageal fistula discovered incidentally during elective upper endoscopy. The patient had previously undergone repair of a descending thoracic aortic aneurysm with a Dacron interposition graft. Esophagoscopy 2 months after the aneurysm repair demonstrated a large mid-esophageal erosion with visualization of the aortic graft at the base. The aortoesophageal fistula had been clinically silent to this point. During preparation for surgery the patient developed large-volume esophageal hemorrhage and died following attempted endovascular repair of the fistula. A review of the literature on the diagnosis and surgical management of aortoesophageal fistula is presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1.
Figure 2.

Similar content being viewed by others

References

  1. RS Montgomery SE Wilson (1996) ArticleTitleThe surgical management of aortoenteric fistulas Surg. Clin. 76 1147–1157 Occurrence Handle1:STN:280:BymH3sbgtlA%3D

    CAS  Google Scholar 

  2. JP Elliott RF Smith DE Szilagyi (1974) ArticleTitleAortoenteric and paraprosthetic-enteric fistulas Am. J. Surg. 108 479–490

    Google Scholar 

  3. TJ Donovan CA Bucknam (1967) ArticleTitleAortoenteric fistula Arch. Surg. 95 810–820 Occurrence Handle1:STN:280:CCeD3MzivVI%3D Occurrence Handle6053962

    CAS  PubMed  Google Scholar 

  4. RW Busuttil W Rees SE Wilson et al. (1979) ArticleTitlePathogenesis of aortoduodenal fistula: experimental and clinical correlates Surgery 85 1–12 Occurrence Handle1:STN:280:CSaD2sjivVw%3D Occurrence Handle153003

    CAS  PubMed  Google Scholar 

  5. MS DeWeese WJ Fry (1962) ArticleTitleSmall bowel erosion following aortic resection J.A.M.A. 179 882–886 Occurrence Handle1:STN:280:CC2D38jit1E%3D Occurrence Handle13885910

    CAS  PubMed  Google Scholar 

  6. RL Heckstall JE Hollander (1998) ArticleTitleAortoesophageal fistula: recognition and diagnosis in the emergency department Ann. Emerg. Med. 32 502–505 Occurrence Handle1:STN:280:DyaK1cvkvVSlsQ%3D%3D Occurrence Handle9774937

    CAS  PubMed  Google Scholar 

  7. ES da Silva FL Tozzi JP Otochi et al. (1999) ArticleTitleAortoesophageal fistula caused aneurysm of the thoracic aorta: successful surgical treatment, case report, and literature review J. Vasc. Surg. 30 1150–1157 Occurrence Handle1:STN:280:DC%2BD3c%2FlsVKktw%3D%3D Occurrence Handle10587402

    CAS  PubMed  Google Scholar 

  8. DL Sigalet JM Laberge M DiLorenzo et al. (1994) ArticleTitleAortoesophageal fistula: congenital and acquired causes J. Pediatr. Surg. 29 1212–1214 Occurrence Handle1:STN:280:ByqC3cngvVc%3D Occurrence Handle7807347

    CAS  PubMed  Google Scholar 

  9. AK Singh LK Kothawla KE Karlson (1976) ArticleTitleTracheoesophageal and aortoesophageal fistulae complicating corrosive esophagitis Chest 70 549–551 Occurrence Handle1:STN:280:CSiD38rjsVA%3D Occurrence Handle975960

    CAS  PubMed  Google Scholar 

  10. II Pipinos DJ Reddy (1999) ArticleTitleSecondary aortoesophageal fistulae Ann. Vasc. Surg. 13 649–652 Occurrence Handle10.1007/s100169900316 Occurrence Handle1:STN:280:DC%2BD3c%2FgvFajtw%3D%3D Occurrence Handle10541624

    Article  CAS  PubMed  Google Scholar 

  11. H Chiari (1914) ArticleTitleUeber Fremdkorpeverletzung des Oesophagus mit Aortenperforation Berlin Klin. Wochenschr. 51 7–9

    Google Scholar 

  12. CD Dossa II Pipinos AD Shepard et al. (1994) ArticleTitlePrimary aortoenteric fistula: Part II Ann. Vasc. Surg. 8 207–211 Occurrence Handle1:STN:280:ByuB2MjktFE%3D Occurrence Handle8198957

    CAS  PubMed  Google Scholar 

  13. S Amin J Luketich A Wald (1998) ArticleTitleAortoesophageal fistula: case report and review of the literature Dig. Dis. Sci. 43 1665–1671 Occurrence Handle10.1023/A:1018850728928 Occurrence Handle1:STN:280:DyaK1czovFGnsw%3D%3D Occurrence Handle9724148

    Article  CAS  PubMed  Google Scholar 

  14. LM Tierney SD Wall RA Jacobs (1984) ArticleTitleAortoesophageal fistula after perigraft abscess with characteristic CT findings J. Clin. Gastroenterol. 6 535–537 Occurrence Handle6512230

    PubMed  Google Scholar 

  15. WM Bogey JH Thomas AS Hermreck (1992) ArticleTitleAortoesophageal fistula: report of a successfully managed case and review of the literature J. Vasc. Surg. 16 90–95 Occurrence Handle10.1067/mva.1992.33990 Occurrence Handle1619730

    Article  PubMed  Google Scholar 

  16. FM Reedy (1988) ArticleTitleEmoblization of aortoesophageal fistula: a new therapeutic approach J. Vasc. Surg. 8 349–350 Occurrence Handle1:STN:280:BieA3szisFE%3D Occurrence Handle3418835

    CAS  PubMed  Google Scholar 

  17. RL Baron RE Koehler FR Gutierrez et al. (1981) ArticleTitleClinical and radiographic manifestations of aortoesophageal fistulas Radiology 141 599–605 Occurrence Handle1:STN:280:Bi2D287htlI%3D Occurrence Handle7302210

    CAS  PubMed  Google Scholar 

  18. D Sosnowik R Greenberg S Bank et al. (1988) ArticleTitleAortoesophageal fistula: early and late endoscopic features Am. J. Gastroenterol. 83 1401–1404 Occurrence Handle1:STN:280:BiaD28%2FitFI%3D Occurrence Handle3195546

    CAS  PubMed  Google Scholar 

  19. FI Khawaja MK Varindani (1987) ArticleTitleAortoesophageal fistula: review of clinical, radiographic, and endoscopic features J. Clin. Gastroenterol. 9 342–344 Occurrence Handle1:STN:280:BiiB1c7kt10%3D Occurrence Handle3611690

    CAS  PubMed  Google Scholar 

  20. MS Baker BH Baker (1982) ArticleTitleAortoesophageal fistula South. Med. J. 75 770–771 Occurrence Handle1:STN:280:Bi2B38vgsFU%3D Occurrence Handle7089636

    CAS  PubMed  Google Scholar 

  21. VL Oliva BT Bui G Leclerc et al. (1997) ArticleTitleAortoesophageal fistula: repair with transluminal placement of a thoracic aortic stent-graft J. Vasc. Interv. Radiol. 8 35–38 Occurrence Handle1:STN:280:ByiC2sjlt1Q%3D Occurrence Handle9025036

    CAS  PubMed  Google Scholar 

  22. K Maruyama T Ishiguchi K Kato et al. (2000) ArticleTitleStent-graft placement for pseudoaneurysm of the aorta Radiation Med. 18 177–185 Occurrence Handle1:STN:280:DC%2BD3M%2FmsFaksw%3D%3D

    CAS  Google Scholar 

  23. I Taniguchi N Takemoto T Yamaga et al. (2002) ArticleTitlePrimary aortoesophageal fistula secondary to thoracic aneurysm Jpn. J. Thorac. Cardiovasc. Surg. 50 263–267 Occurrence Handle12073606

    PubMed  Google Scholar 

  24. OJ Lee SH Kim (2002) ArticleTitleAortoesophageal fistula associated with tuberculous medistinitis, mimicking esophageal dieulafoy’s disease J. Korean Med. Sci. 17 266–269 Occurrence Handle11961316

    PubMed  Google Scholar 

  25. JD Luketich E Sommers BP Griffith (1996) ArticleTitleSuccessful management of secondary aortoesophageal fistula Ann. Thorac. Surg. 62 1852–1854 Occurrence Handle10.1016/S0003-4975(96)00554-1 Occurrence Handle1:STN:280:ByiC3MnjtF0%3D Occurrence Handle8957407

    Article  CAS  PubMed  Google Scholar 

  26. AK Madan TA Santora VJ DiSesa (2000) ArticleTitleExtra-anatomic bypass grafting for aortoesophageal fistula: a logical operation J. Vasc. Surg. 32 1030–1033 Occurrence Handle10.1067/mva.2000.107767 Occurrence Handle1:STN:280:DC%2BD3M%2FltlGqsA%3D%3D Occurrence Handle11054236

    Article  CAS  PubMed  Google Scholar 

  27. JS Coselli ES Crawford (1990) ArticleTitlePrimary aortoesophageal fistula from aortic aneurysm: successful surgical treatment by use of pedicle omental graft J. Vasc. Surg. 12 269–277 Occurrence Handle10.1067/mva.1990.22359 Occurrence Handle1:STN:280:By%2BA2snlsFM%3D Occurrence Handle2144597

    Article  CAS  PubMed  Google Scholar 

  28. RC Lui FE Johnson JH Horovitz et al. (1987) ArticleTitleAortoesohageal fistula: case report and literature review J. Vasc. Surg. 6 379–382 Occurrence Handle10.1067/mva.1987.avs0060379 Occurrence Handle1:STN:280:BieD3M7lsFY%3D Occurrence Handle3309380

    Article  CAS  PubMed  Google Scholar 

  29. B Debras B Enon O Kanane et al. (1996) ArticleTitleSuccessful management of an aortoesophageal fistula using a cryopreserved arterial allograft Ann. Vasc. Surg. 10 292–296 Occurrence Handle1:STN:280:BymA1crhtl0%3D Occurrence Handle8792999

    CAS  PubMed  Google Scholar 

  30. PH Wickstrom JM Streitz RV Erickson et al. (1997) ArticleTitleRepair of aortoesophageal fistula after aortic grafting Ann. Thorac. Surg. 64 253–255 Occurrence Handle10.1016/S0003-4975(97)00477-3 Occurrence Handle1:STN:280:ByiA2sblsl0%3D Occurrence Handle9236378

    Article  CAS  PubMed  Google Scholar 

  31. UO Oppell Particlevon M Groot Particlede C Thierfelder et al. (1991) ArticleTitleSuccessful management of aortoesophageal fistula due to thoracic aortic aneurysm Ann. Thorac. Surg. 52 1168–1170 Occurrence Handle1953145

    PubMed  Google Scholar 

  32. P Cronen N Snow D Nightingale (1982) ArticleTitleAortoesophageal fistula secondary to reflux esophagitis Ann. Thorac. Surg. 33 78–80 Occurrence Handle1:STN:280:Bi2C2MbitVA%3D Occurrence Handle6978112

    CAS  PubMed  Google Scholar 

  33. MJ Reardon RJ Brewer SA LeMaire et al. (2000) ArticleTitleSurgical management of primary aortoesophageal fistula secondary to thoracic aneurysm Ann. Thorac. Surg. 69 967–970 Occurrence Handle10.1016/S0003-4975(99)01087-5 Occurrence Handle1:STN:280:DC%2BD3c3ht1yntw%3D%3D Occurrence Handle10750807

    Article  CAS  PubMed  Google Scholar 

  34. MH Wu WW Lai (1992) ArticleTitleAortoesophageal fistula induced by foreign bodies Ann. Thorac. Surg. 54 155–156 Occurrence Handle1:STN:280:By2A3cvht1Q%3D Occurrence Handle1610230

    CAS  PubMed  Google Scholar 

  35. T Yamada H Sato M Seki et al. (1996) ArticleTitleSuccessful salvage of aortoesophageal fistula caused by a fish bone Ann. Thorac. Surg. 61 1843–1845 Occurrence Handle10.1016/0003-4975(96)00001-X Occurrence Handle1:STN:280:BymB38rislI%3D Occurrence Handle8651805

    Article  CAS  PubMed  Google Scholar 

  36. RS Wong A Champlin T Temes et al. (1996) ArticleTitleAortoesophageal fistula after repair of descending aortic dissection Ann. Thorac. Surg. 62 588–590 Occurrence Handle10.1016/0003-4975(96)00236-6 Occurrence Handle1:STN:280:BymA3cblvFI%3D Occurrence Handle8694638

    Article  CAS  PubMed  Google Scholar 

  37. TS Chughtai NM Sheiner (1998) ArticleTitleSuccessful repair of aortoesophageal fistula secondary to traumatic pseudoaneurysm Ann. Thorac. Surg. 66 936–938 Occurrence Handle10.1016/S0003-4975(98)00647-X Occurrence Handle1:STN:280:DyaK1cvjvFyqtw%3D%3D Occurrence Handle9768959

    Article  CAS  PubMed  Google Scholar 

  38. B Leobon D Roux H Rousseau et al. (2002) ArticleTitleEndovascular treatment of thoracic aortic fistulas Ann. Thorac. Surg. 74 247–249 Occurrence Handle10.1016/S0003-4975(02)03466-5 Occurrence Handle12118773

    Article  PubMed  Google Scholar 

  39. RC Doorn ParticleVan J Reekers BA Mol Particlede et al. (2002) ArticleTitleAortoesophageal fistula secondary to mycotic thoracic aortic aneurysm: endovascular repair and transhiatal esophagectomy J. Endovasc. Ther. 9 212–217 Occurrence Handle12010103

    PubMed  Google Scholar 

  40. SE Bond CL McGuinness JF Reidy et al. (2001) ArticleTitleRepair of secondary aortoesophageal fistula by endoluminal stent-grafting J. Endovasc. Ther. 8 597–601 Occurrence Handle1:STN:280:DC%2BD38%2FntFGqsA%3D%3D Occurrence Handle11797975

    CAS  PubMed  Google Scholar 

  41. N Kato H Tadanori K Tanaka et al. (2000) ArticleTitleAortoesophageal fistula-relief of massive hematemesis with an endovascular stent-graft Eur. J. Radiol. 34 63–66 Occurrence Handle10.1016/S0720-048X(99)00107-2 Occurrence Handle1:STN:280:DC%2BD3cvgtlyiug%3D%3D Occurrence Handle10802211

    Article  CAS  PubMed  Google Scholar 

  42. R Carter GA Mulder EN Snyder et al. (1978) ArticleTitleAortoesophageal fistula Am. J. Surg. 136 26–30 Occurrence Handle1:STN:280:CSeB3szhvF0%3D Occurrence Handle677387

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA

    Matthew Martin MD, Scott Steele MD, Philip Mullenix MD, Mohamad Haque MD & Charles Andersen MD, FACS

Authors
  1. Matthew Martin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Scott Steele MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philip Mullenix MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohamad Haque MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Charles Andersen MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philip Mullenix MD.

About this article

Cite this article

Martin, M., Steele, S., Mullenix, P. et al. Endoscopic Diagnosis of a Clinically Silent Aortoesophageal Fistula: Case Report and Review of the Literature. Ann Vasc Surg 18, 352–356 (2004). https://doi.org/10.1007/s10016-004-0027-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10016-004-0027-4

Keywords

Search

Navigation