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

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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.

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Authors and Affiliations

  1. Division of General and Gastrointestinal Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Takeyuki Wada, Hiroya Takeuchi, Naoki Fujimura, Rieko Nakamura, Takashi Oyama, Tsunehiro Takahashi, Norihito Wada, Yoshiro Saikawa & Yuko Kitagawa

  2. Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hideyuki Shimizu & Ryohei Yozu

Authors
  1. Takeyuki Wada
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  2. Hiroya Takeuchi
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  3. Naoki Fujimura
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  4. Rieko Nakamura
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  5. Takashi Oyama
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  6. Tsunehiro Takahashi
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  7. Norihito Wada
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  8. Yoshiro Saikawa
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  9. Hideyuki Shimizu
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  10. Ryohei Yozu
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  11. Yuko Kitagawa
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Corresponding author

Correspondence to Hiroya Takeuchi.

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Wada, T., Takeuchi, H., Fujimura, N. et al. Intractable esophago-mediastinal fistula as a rare complication following thoracoabdominal aortic replacement. Esophagus 8, 277–281 (2011). https://doi.org/10.1007/s10388-011-0287-3

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  • DOI: https://doi.org/10.1007/s10388-011-0287-3

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