Endoscopic View of the Aorta Through the Oesophagus: An Unusual Complication Post Thoracic Endovascular Aortic Repair.

IF 0.6 Q4 GASTROENTEROLOGY & HEPATOLOGY Case Reports in Gastrointestinal Medicine Pub Date : 2025-01-10 eCollection Date: 2025-01-01 DOI:10.1155/crgm/6277906
Kushedison Yunus, Hasib Ahmadzai, Eleanor Noreen Dunlop, Andrew Thomson
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Abstract

We present a case of an 80-year-old female who presented with chest pain, vomiting and night sweats a few weeks post thoracic endovascular aortic aneurysm repair (TEVAR). A computed tomography (CT) scan demonstrated a type 1B endoleak for which she underwent a repeat TEVAR. Postoperatively, she developed fever, dysphagia, haematemesis and melaena. CT angiography subsequently confirmed an aorto-oesophageal fistula (AEF). Gastroscopy was performed to confirm this and found an ovoid oesophageal perforation with visible aortic graft and purulent fluid. Serial endoscopic oesophageal stents were placed and the patient recovered after an oesophageal Ultraflex stent was placed. Unfortunately, however, the patient was found unresponsive at home with black vomitus and in cardiac arrest and passed away 18 months after her initial endoscopic procedure. This case highlights that AEF is a complication following a TEVAR procedure. This can be managed temporarily with oesophageal stent placement and an Ultraflex stent in the longer term. However, oesophageal stent placement is not curative in cases of significant oesophageal perforation as it does not lead to lead to closure of a large defect.

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经食道主动脉的内窥镜观察:胸腔血管内主动脉修复术后的一种罕见并发症。
我们报告一例80岁的女性患者,在胸椎血管内动脉瘤修复术(TEVAR)后几周出现胸痛、呕吐和盗汗。计算机断层扫描(CT)显示1B型腔内漏,她接受了重复TEVAR。术后出现发热、吞咽困难、呕血、黑黑等症状。CT血管造影证实主动脉-食管瘘(AEF)。胃镜检查证实了这一点,发现一个卵形食管穿孔,可见主动脉移植和脓性液体。在内镜下放置一系列食管支架,患者在放置食管Ultraflex支架后康复。然而,不幸的是,患者在家中被发现无反应,有黑色呕吐物和心脏骤停,并在首次内窥镜手术18个月后去世。本病例强调AEF是TEVAR手术后的并发症。这可以暂时通过放置食管支架和长期使用Ultraflex支架来解决。然而,食管支架置入术不能治愈严重食管穿孔的病例,因为它不能导致大缺损的闭合。
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来源期刊
Case Reports in Gastrointestinal Medicine
Case Reports in Gastrointestinal Medicine GASTROENTEROLOGY & HEPATOLOGY-
自引率
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发文量
33
审稿时长
14 weeks
期刊最新文献
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