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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(3): 217–220. doi:10.14735/amgh2018217.

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

Eva Evinová1, Ondřej Urban  2,3, Dušan Kučera4, Petr Fojtík  5, Jaroslav Krátký  6, Tomáš Málek  7, Přemysl Falt  8

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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.


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

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