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J Thorac Cardiovasc Surg 2006;131:1409-1410
© 2006 The American Association for Thoracic Surgery

Brief Communication

Surgical and endovascular treatment of secondary aortoesophageal fistula

Enrico Maria Marone, MD a , * , Paolo Baccari, MD b , Chiara Brioschi, MD a , Yamume Tshomba, MD a , Carlo Staudacher, MD b , Roberto Chiesa, MD a

a Department of Vascular Surgery
b General Surgery, "Vita-Salute" University, Scientific Institute H. San Raffaele, Milan, Italy.

Received for publication November 29, 2005; accepted for publication January 13, 2006.

* Address for reprints: Enrico Maria Marone, MD, Chirurgia Vascolare, IRCCS H. San Raffaele, Via Olgettina 60, 20132 Milano, Italy. (Email: marone.enrico@hsr.it).

The first 20% of the full text of this article appears below.


Figure 1
Drs Tshomba, Marone (standing), Chiesa (seated), Brioschi (standing), and Baccari (seated) (left to right).


Aortoesophageal fistula is an uncommon and highly fatal condition, even if opportunely treated. In rare cases it has been encountered in association with extensive corrosive injury. No cases of successful endovascular repair of aortoesophageal fistula caused by corrosives are reported in the English-language literature. We report a case of severe esophagogastritis caused by massive ingestion of hydrochloric acid complicated by aortoesophageal fistula. Combined surgical and endovascular treatment by means of a stent graft proved to be successful.

Clinical Summary

A 20-year-old man was brought to the emergency department after ingestion of hydrochloric acid with suicidal intent. At admission, he required endotracheal intubation, fluid resuscitation, and correction of metabolic acidosis. Endoscopy showed edema and necrosis of the palate, tongue, pharynx, larynx, epiglottis, and arytenoids. Computed tomography showed marked edematous thickening of the esophageal and gastric walls (Figure 1) and posterior gastric wall perforation with perigastric . . . [Full Text of this Article]




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