Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies
A 59-year-old man with past medical history of thoracic aortic aneurysm treated with thoracic endovascular aortic repair presented with melena for 2 weeks. Initial EGD did not reveal the source of bleeding and showed normal esophagus; abdominal arteriogram did not reveal a fistulous communication an...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/7219034 |
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| author | Seifeldin Hakim Mihajlo Gjeorgjievski Lohit Garg Molly Orosey Tusar Desai |
| author_facet | Seifeldin Hakim Mihajlo Gjeorgjievski Lohit Garg Molly Orosey Tusar Desai |
| author_sort | Seifeldin Hakim |
| collection | DOAJ |
| description | A 59-year-old man with past medical history of thoracic aortic aneurysm treated with thoracic endovascular aortic repair presented with melena for 2 weeks. Initial EGD did not reveal the source of bleeding and showed normal esophagus; abdominal arteriogram did not reveal a fistulous communication and initial CTA showed normal position of the aortic graft stent without endoleak. The sixth EGD revealed a submucosal tumor-like projection in the upper esophagus and stigmata of recent bleeding. Another thoracic endovascular aortic repair with stent was placed over the old graft for presumed aortoesophageal fistula. Poststent upper gastrointestinal series with contrast showed extravasation of the contrast from the esophagus and CTA showed fistulous tract between aorta and esophagus. The patient refused definitive surgical repair despite having infected aortic graft; jejunostomy tube was placed and life-long suppressive antibiotic treatment was given and the patient is doing well at 2-year follow-up. |
| format | Article |
| id | doaj-art-2f4e75d008f44b718ee78b06b1d45386 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-2f4e75d008f44b718ee78b06b1d453862025-02-03T06:48:05ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362016-01-01201610.1155/2016/72190347219034Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging StudiesSeifeldin Hakim0Mihajlo Gjeorgjievski1Lohit Garg2Molly Orosey3Tusar Desai4Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USADepartment of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USADepartment of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USADepartment of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USADepartment of Gastroenterology, William Beaumont Hospital, Royal Oak, MI 48073, USAA 59-year-old man with past medical history of thoracic aortic aneurysm treated with thoracic endovascular aortic repair presented with melena for 2 weeks. Initial EGD did not reveal the source of bleeding and showed normal esophagus; abdominal arteriogram did not reveal a fistulous communication and initial CTA showed normal position of the aortic graft stent without endoleak. The sixth EGD revealed a submucosal tumor-like projection in the upper esophagus and stigmata of recent bleeding. Another thoracic endovascular aortic repair with stent was placed over the old graft for presumed aortoesophageal fistula. Poststent upper gastrointestinal series with contrast showed extravasation of the contrast from the esophagus and CTA showed fistulous tract between aorta and esophagus. The patient refused definitive surgical repair despite having infected aortic graft; jejunostomy tube was placed and life-long suppressive antibiotic treatment was given and the patient is doing well at 2-year follow-up.http://dx.doi.org/10.1155/2016/7219034 |
| spellingShingle | Seifeldin Hakim Mihajlo Gjeorgjievski Lohit Garg Molly Orosey Tusar Desai Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies Case Reports in Gastrointestinal Medicine |
| title | Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies |
| title_full | Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies |
| title_fullStr | Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies |
| title_full_unstemmed | Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies |
| title_short | Atypical Aortoesophageal Fistula with Atypical and Delayed Presentation and Negative Imaging Studies |
| title_sort | atypical aortoesophageal fistula with atypical and delayed presentation and negative imaging studies |
| url | http://dx.doi.org/10.1155/2016/7219034 |
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