Gastroenterologie
a hepatologie

Successful treatment of bleeding from aortoesophageal fistula with a metallic self-expandable stent

Eva Evinová¹, Ondřej Urban ^{Orcid.org  2,3}, Dušan Kučera⁴, Petr Fojtík ^{Orcid.org  5}, Jaroslav Krátký ^{Orcid.org  6}, Tomáš Málek ^{Orcid.org  7}, Přemysl Falt ^{Orcid.org  8}

+ Affiliation
¹ Centrum péče o zažívací trakt, Vítkovická nemocnice, a. s., Ostrava
² II. interní klinika – gastroenterologie a geriatrie LF UP a FN Olomouc
³ Katedra interních oborů, LF UK v Hradci Králové
⁴ Vaskulární centrum, Vítkovická nemocnice a. s., Ostrava
⁵ Centrum péče o zažívací trakt, Vítkovická nemocnice a. s., Ostrava
⁶ Radiologické oddělení, Vítkovická nemocnice a. s., Ostrava
⁷ Anesteziologicko-resuscitační oddělení, Vítkovická nemocnice a. s., Ostrava
⁸ II. interní klinika – gastroenterologická a geriatrická, LF UP a FN Olomouc

Summary

We present a case of a 70-year-old patient diagnosed with acute bleeding from an aortoesophageal fistula, which was treated by endoscopic insertion of a self-expandable stent. Although the haemostasis was successful, the patient died from complications. Aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding with high mortality and morbidity. Thoracic aortic aneurysm is the most common aetiology among other causes such as oesophageal carcinoma, foreign body ingestion, trauma or iatrogenic causes. It is an urgent condition that has often lethal consequences, especially due to a symptoms-free period followed by a massive haemorrhage. Nowadays, the diagnostic standard is computed tomography with angiography. The therapeutic solution consists in either a one-step (surgery) or two-step approach (endovascular treatment). However, the mortality from of aortoesophageal fistula is still high and requires multidisciplinary team collaboration to ensure a well-chosen therapeutic approach, and management of septic complications.

Keywords

aortoesophageal fistula, endoscopy, gastrointestinal bleeding, self-expandable metallic stent

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