scholarly journals Aorto-esophageal fistula associated with vascular ring: Double the arch trouble

2017 ◽  
Vol 3 (3) ◽  
pp. 24
Author(s):  
Umar S. Boston ◽  
Peter E. Fischer ◽  
Shyam K. Sathanandam ◽  
Christopher J. Knott-Craig
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Gastrointestinal Bleeding ◽  
Aortic Arch ◽  
Upper Gastrointestinal Bleeding ◽  
Vascular Ring ◽  
Esophageal Fistula ◽  
Rare Form ◽  
Thoracic Aneurysms ◽  
Upper Gastrointestinal

Aorto-esophageal fistula (AEF) is a rare form of upper gastrointestinal bleeding that is associated with high mortality if not surgically addressed. It is most commonly associated with descending thoracic aneurysms and foreign body ingestion. We report a case of surgical treatment of AEF associated with double aortic arch vascular ring.

scholarly journals Clinical and endoscopic features of aorto-duodenal fistula resulting in definitive diagnosis: an observational study

2020 ◽  
Author(s):  
Chikamasa Ichita ◽  
Akiko Sasaki ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Vital Signs ◽  
Diagnostic Methods ◽  
Upper Endoscopy ◽  
Duodenal Fistula ◽  
Endoscopic Characteristics ◽  
Upper Gastrointestinal

Abstract Background: An aorto-duodenal fistula presents with upper gastrointestinal bleeding and hematemesis. Early diagnosis is difficult, and the disease is associated with high mortality. Sometimes, a small amount of bleeding, known as herald bleed, occurs repeatedly and may be judged as upper gastrointestinal bleeding, prompting emergency upper endoscopy. Diagnostic methods and surgical treatment during herald bleeding are important for saving lives. However, most fistulas form in the horizontal duodenum, and active bleeding is rarely found in patients with herald bleeding. Moreover, an aorto-duodenal fistula is rarely diagnosed based on upper endoscopy alone. Methods: The present study examined the clinical and endoscopic characteristics of aorto-duodenal fistula in eight patients who underwent upper endoscopy before diagnosis at our hospital. It also sought to clarify how aorto-duodenal fistula can be appropriately diagnosed. Results: All patients had a history of aortic treatment, and many could not be diagnosed by computed tomography scan or upper endoscopy alone. Regarding the endoscopic findings, patients were seen to have stent/vascular prosthesis exposure, which is diagnostic of aorto-duodenal fistula as well as pulsatile lesions and massive fresh bleeding of obscure origin in the duodenum. Conclusions: If the diagnosis is unclear, clinicians may need to observe the horizontal duodenum using a fitted tip attachment or long scope. Since vital signs may fluctuate during endoscopy, a series of tests should be performed immediately. Proactive placement of marking clips in likely areas of the fistula may facilitate diagnosis via computed tomography. The present results demonstrate that proper diagnosis and prompt surgical treatment save lives in patients with aorto-duodenal fistula.

scholarly journals Approach to Upper Gastrointestinal Bleeding - When to Treat?

1990 ◽  
Vol 4 (9) ◽  
pp. 647-649
Author(s):  
P Rutgeerts
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Fatal Outcome ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Life Threatening ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding from peptic ulcer is a life threatening emergency. Clinical risk factors for fatal outcome have been defined, and endoscopic predictors for rebleeding have been identified. Active ulcer bleeding at endoscopy carries an 80% chance of persistent or recurrent bleeding. A non bleeding visible vessel is associated with a 50% chance of rebleeding. These endoscopic lesions should be treated endoscopically. Failure to obtain definitive hemostasis endoscopically will necessitate emergency surgical treatment.

scholarly journals Upper Gastrointestinal Bleeding Secondary to an Aberrant Right Subclavian Artery-Esophageal Fistula: A Case Report and Review of the Literature

2007 ◽  
Vol 21 (6) ◽  
pp. 389-392 ◽  
Author(s):  
Adam Millar ◽  
Alaa Rostom ◽  
Pasteur Rasuli ◽  
Nav Saloojee
Keyword(s):  
Gastrointestinal Bleeding ◽  
Subclavian Artery ◽  
Upper Gastrointestinal Bleeding ◽  
Aberrant Right Subclavian Artery ◽  
Esophageal Fistula ◽  
Endotracheal Tubes ◽  
Medline Search ◽  
High Index Of Suspicion ◽  
Upper Gastrointestinal ◽  
Current Report

An aberrant right subclavian artery (ARSA) is a common aortic arch abnormality. A case of a 57-year-old man presenting with melena and hypotension secondary to an ARSA-esophageal fistula is reported. The current report is unique because it is the first reported case of ARSA-esophageal fistula associated with prior esophagectomy and gastric pull-up. A MedLine search was performed for ARSA-esophageal fistula cases, which were then compared with the present case. Because this patient had no vascular conduits, nasogastric or endotracheal tubes, the fistula likely occurred secondary to the previous surgery. This case is unusual because the patient survived the original hemorrhage associated with the ARSA-esophageal fistula.An ARSA-esophageal fistula is a rare, but potentially fatal cause of upper gastrointestinal bleeding. A high index of suspicion is needed to make the diagnosis. This condition should be considered in patients with risk factors combined with hemodynamically significant gastrointestinal bleeding.

A Case of an Upper Gastrointestinal Bleeding Due to a Ruptured Dissection of a Right Aortic Arch

2003 ◽  
Vol 26 (5) ◽  
Author(s):  
Christine Born ◽  
Andreas Forster ◽  
Clemens Rock ◽  
Klaus-J�rgen Pfeifer ◽  
Johannes Rieger ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Aortic Arch ◽  
Upper Gastrointestinal Bleeding ◽  
Right Aortic Arch ◽  
Upper Gastrointestinal

Haemorrhage from the pancreatic duct: A rare form of upper gastrointestinal bleeding

1984 ◽  
Vol 71 (2) ◽  
pp. 137-140 ◽  
Author(s):  
W. van Rooyen ◽  
M. van Blankenstein ◽  
M. Eeftinck Schattenkerk ◽  
J. E. de Vries ◽  
H. Obertop ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Pancreatic Duct ◽  
Upper Gastrointestinal Bleeding ◽  
Rare Form ◽  
Upper Gastrointestinal

scholarly journals Upper Gastrointestinal Bleeding Secondary to an Incidental, Impacted Foreign Body in the Duodenum

Cureus ◽  
2020 ◽  
Author(s):  
Emuobor Odeghe ◽  
Azeberoje Osueni ◽  
Opeyemi O Owoseni ◽  
Funmi Adeniyi ◽  
Olufunmilayo Lesi
Keyword(s):  
Foreign Body ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Impacted Foreign Body ◽  
Upper Gastrointestinal
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