Ćeranić D, Nikolić S, Lučev J, Slanič A, Bujas T, Ocepek A, Skok P. Fatal bleeding due to an aorto-esophageal fistula: A case report and literature review . World J Clin Cases 2022; 10(31): 11493-11499 [PMID: 36387793 DOI: 10.12998/wjcc.v10.i31.11493]
Corresponding Author of This Article
Davorin Ćeranić, MD, PhD, Associate Chief Physician, Department of Gastroenterology, Internal Medicine Clinic, University Medical Centre Maribor, Ljubljanska c.5, Maribor 2000, Slovenia. davorin.ceranic@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2022; 10(31): 11493-11499 Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11493
Fatal bleeding due to an aorto-esophageal fistula: A case report and literature review
Davorin Ćeranić, Sara Nikolić, Jernej Lučev, Aleš Slanič, Tatjana Bujas, Andreja Ocepek, Pavel Skok
Davorin Ćeranić, Sara Nikolić, Andreja Ocepek, Pavel Skok, Department of Gastroenterology, Internal Medicine Clinic, University Medical Centre Maribor, Maribor 2000, Slovenia
Jernej Lučev, Aleš Slanič, Department of Radiology, University Medical Centre Maribor, Maribor 2000, Slovenia
Tatjana Bujas, Department of Pathology, University Medical Centre Maribor, Maribor 2000, Slovenia
Author contributions: Ćeranić D and Skok P contributed to the conception and design; Ćeranić D, Nikolić S, Lučev J, Slanič A, Ocepek A, and Bujas T performed the data collection; Nikolić S, Lučev J, Slanič A, and Bujas T contributed to the data analysis; Ćeranić D, Skok P, Ocepek A, and Nikolić S wrote the manuscript; All authors contributed to the manuscript editing.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Davorin Ćeranić, MD, PhD, Associate Chief Physician, Department of Gastroenterology, Internal Medicine Clinic, University Medical Centre Maribor, Ljubljanska c.5, Maribor 2000, Slovenia. davorin.ceranic@gmail.com
Received: May 7, 2022 Peer-review started: May 7, 2022 First decision: June 27, 2022 Revised: July 27, 2022 Accepted: September 23, 2022 Article in press: September 23, 2022 Published online: November 6, 2022 Processing time: 172 Days and 5.6 Hours
Abstract
BACKGROUND
Aorto-esophageal fistula is an extremely rare cause of acute upper gastrointestinal bleeding (UGIB).
CASE SUMMARY
We present a case of an 80-year-old woman with esophageal cancer who was admitted to our department with hemorrhagic shock due to UGIB. During the diagnostic procedure, emergency computed tomography angiography was performed and confirmed aorto-esophageal fistula. Interventional radiologists inserted a stent graft into the aorta, successfully closing the fistula. Unfortunately, the patient later died of heart failure following irreversible hemorrhagic shock. Autopsy confirmed the aorto-esophageal fistula, which formed 1 cm below the distal edge of the stent previously inserted into the esophagus for a malignant stricture.
CONCLUSION
There are very rare causes of UGIB. Although clinical decisions are made during the diagnostic workup of these patients, we must be aware of the limitations of various therapeutic options, even the most contemporary.
Core Tip: Acute upper gastrointestinal bleeding (UGIB) is a life-threatening condition. Although most UGIB cases have a benign course, only a few have a severe and fatal outcome. Improved diagnostic and therapeutic options have been made possible, in particular, by technological advances in interventional endoscopy, radiology and minimally invasive, laparoscopic surgery. In the paper, the authors present a patient with UGIB caused by an aorto-esophageal fistula, which formed due to a stent inserted into the middle third of the esophagus for advanced cancer. Despite appropriate and timely clinical decisions, the outcome of treatment was fatal.
