Combined endovascular stent grafting and endoscopic injection of fibrin sealant for aortoenteric fistula complicating esophagectomy

J Vasc Surg. 2004 Dec;40(6):1234-7. doi: 10.1016/j.jvs.2004.08.044.

Abstract

A 67-year-old man with previous total gastrectomy and roux-en-Y esophagojejunostomy had hematemesis 4 weeks after esophagectomy performed because of carcinoma of the esophagus. Investigation showed an aortojejunal fistula with a thoracic aortic pseudoaneurysm. Endovascular stent grafting of the pseudoaneurysm, followed by endoscopic injection of fibrin sealant for the fistula, was performed, and the infection was controlled with broad-spectrum antibiotic agents together with drainage and daily irrigation of the pseudoaneurysm sac. The fistula subsequently healed. The patient remained well 14 months after the procedure; follow-up computed tomograms at 12 months did not show any pseudoaneurysm, and there was no evidence of reopening of the fistula.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy
  • Aortic Aneurysm, Thoracic / etiology
  • Aortic Aneurysm, Thoracic / therapy
  • Aortic Diseases / etiology
  • Aortic Diseases / therapy*
  • Blood Vessel Prosthesis Implantation / methods*
  • Drainage
  • Endoscopy, Digestive System
  • Esophageal Neoplasms / surgery
  • Esophagectomy / adverse effects*
  • Fibrin Tissue Adhesive / therapeutic use*
  • Humans
  • Intestinal Fistula / etiology
  • Intestinal Fistula / therapy*
  • Male
  • Stents
  • Therapeutic Irrigation
  • Thoracotomy
  • Treatment Outcome

Substances

  • Fibrin Tissue Adhesive