Claire E. White-Dzuro , Bryan D. Steitz , Eunice Y. Huang , Christopher M. Baron , Lyndy Wilcox , Jamie R. Robinson
{"title":"儿童异物误食后动脉食管瘘的血管内诊断和治疗:两个病例的故事","authors":"Claire E. White-Dzuro , Bryan D. Steitz , Eunice Y. Huang , Christopher M. Baron , Lyndy Wilcox , Jamie R. Robinson","doi":"10.1016/j.epsc.2024.102912","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>An arterio-esophageal fistula (AEF) is an abnormal communication between an artery and the esophagus. While a rare complication, patients are at risk of disastrous hemorrhage. The goal of this study is to highlight endovascular management options of AEF in children.</div></div><div><h3>Case series</h3><div>We present two cases of children with AEF. Both children were female, 3 years of age or younger, and had hematemesis upon presentation. For each patient, esophageal foreign body impaction was confirmed with radiography prompting emergent surgery. A multidisciplinary team was involved in the management of both patients, consisting of combinations of pediatric surgery, pediatric otolaryngology, pediatric cardiothoracic surgery and pediatric interventional radiology. Angiography successfully localized the AEF in both patients after several hours of unsuccessful open dissection and failed attempts at hemorrhage control. Further, angiographic embolization successfully controlled the hemorrhage in one patient. One of the two children experienced cardiac arrest intraoperatively due to hemorrhagic shock, which resulted in their death.</div></div><div><h3>Conclusion</h3><div>Our study highlights the importance of a multidisciplinary team to care for patients with AEF and the role of endovascular techniques in aiding rapid diagnosis and potential management of the fistula.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endovascular diagnosis and treatment of arterio-esophageal fistula after foreign body ingestion in children: A tale of two cases\",\"authors\":\"Claire E. White-Dzuro , Bryan D. Steitz , Eunice Y. Huang , Christopher M. Baron , Lyndy Wilcox , Jamie R. Robinson\",\"doi\":\"10.1016/j.epsc.2024.102912\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>An arterio-esophageal fistula (AEF) is an abnormal communication between an artery and the esophagus. While a rare complication, patients are at risk of disastrous hemorrhage. The goal of this study is to highlight endovascular management options of AEF in children.</div></div><div><h3>Case series</h3><div>We present two cases of children with AEF. Both children were female, 3 years of age or younger, and had hematemesis upon presentation. For each patient, esophageal foreign body impaction was confirmed with radiography prompting emergent surgery. A multidisciplinary team was involved in the management of both patients, consisting of combinations of pediatric surgery, pediatric otolaryngology, pediatric cardiothoracic surgery and pediatric interventional radiology. Angiography successfully localized the AEF in both patients after several hours of unsuccessful open dissection and failed attempts at hemorrhage control. Further, angiographic embolization successfully controlled the hemorrhage in one patient. One of the two children experienced cardiac arrest intraoperatively due to hemorrhagic shock, which resulted in their death.</div></div><div><h3>Conclusion</h3><div>Our study highlights the importance of a multidisciplinary team to care for patients with AEF and the role of endovascular techniques in aiding rapid diagnosis and potential management of the fistula.</div></div>\",\"PeriodicalId\":45641,\"journal\":{\"name\":\"Journal of Pediatric Surgery Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-10-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Surgery Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213576624001404\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Surgery Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213576624001404","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
Endovascular diagnosis and treatment of arterio-esophageal fistula after foreign body ingestion in children: A tale of two cases
Introduction
An arterio-esophageal fistula (AEF) is an abnormal communication between an artery and the esophagus. While a rare complication, patients are at risk of disastrous hemorrhage. The goal of this study is to highlight endovascular management options of AEF in children.
Case series
We present two cases of children with AEF. Both children were female, 3 years of age or younger, and had hematemesis upon presentation. For each patient, esophageal foreign body impaction was confirmed with radiography prompting emergent surgery. A multidisciplinary team was involved in the management of both patients, consisting of combinations of pediatric surgery, pediatric otolaryngology, pediatric cardiothoracic surgery and pediatric interventional radiology. Angiography successfully localized the AEF in both patients after several hours of unsuccessful open dissection and failed attempts at hemorrhage control. Further, angiographic embolization successfully controlled the hemorrhage in one patient. One of the two children experienced cardiac arrest intraoperatively due to hemorrhagic shock, which resulted in their death.
Conclusion
Our study highlights the importance of a multidisciplinary team to care for patients with AEF and the role of endovascular techniques in aiding rapid diagnosis and potential management of the fistula.