Emergency Endovascular Repair of an Aortoesophageal Fistula Caused by a Foreign Body

Abstract

PURPOSE: To report stent-graft treatment of an aortoesophageal fistula caused by a foreign body. CASE REPORT: A 32-year-old man was admitted with massive upper gastrointestinal bleeding 10 days after swallowing a fish bone. Computed tomography demonstrated a fistula from the proximal descending thoracic aorta to the mid esophagus. The bleeding was initially controlled by inflating a Sengstaken-Blakemore tube. A 28-mm x 16-cm Talent stent-graft was delivered transfemorally to repair the aortic defect; the esophageal injury was repaired primarily using a pedicled intercostal muscle flap via a right thoracotomy. Chest radiography at 12 months showed no migration of the stent-graft. Blood parameters of infection were normal; the patient remains well 18 months after stent-graft implantation. CONCLUSIONS: This case illustrates stent-graft treatment of a life-threatening hemorrhage from an aortoesophageal fistula.