A 73-year-old man presented with melena. After a thorough workup including esophageal endoscopy, computed tomography scans, and esophagography, the diagnosis of secondary aortoesophageal fistula was made. Two years previously, he had undergone endovascular stent-graft repair for the dissection of his descending thoracic aorta. Because of the generally poor condition of the patient and the high risk of any aggressive surgical intervention, we inserted a covered self-expanding esophageal stent on postadmission day 18. Esophagography after insertion did not show any evidence of a leak of contrast medium. Despite treatment with antibiotics, he developed sepsis and expired on day 52, but rebleeding did not occur in this period. We consider insertion of a covered self-expanding esophageal stent as a feasible option in the management of secondary aortoesophageal fistula in high-risk patients.
Onodera, M., Inoue, Y., Fujino, Y., Kikuchi, S., & Endo, S. (2013). A Case of Secondary Aortoesophageal Fistula Inserted a Covered Self-Expanding Esophageal Stent to Control Gastrointestinal Bleeding. Case Reports in Gastrointestinal Medicine, 2013, 1–3. https://doi.org/10.1155/2013/857135