| A case of an aortoesophageal fistula presenting as a Dieulafoy-like lesion |
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Dae Jin Kim, Yun Jin Chung, Ju Young Lee, Wan Suk Lee, Hyun Chaol Lee, Min Kyu Jung, Seong Woo Jeon |
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경희대학교 의과대학 순환기내과학교실 |
| 증례 : Dieulafoy양 병변으로 발현된 대동맥식도루 1예 |
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김대진&#;정윤진&#;이주영&#;이완석&#;이현철&#;정민규&#;전성우, Yun Jin Chung, Ju Young Lee, Wan Suk Lee, Hyun Chaol Lee, Min Kyu Jung, Seong Woo Jeon |
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| Abstract |
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A 68-year-old woman visited our emergency center because of hematemesis. An emergency endoscopy showed an
exposed vessel with blood flowing into the upper esophagus. Angiography revealed the presence of extravasation of
contrast at the level of the aortic arch and a tortuous fistula between the aortic arch and esophagus. Chest computerized
tomography demonstrated the presence of an aortoesophageal fistula and air bubbles inside the fistula. The patient had
emergency surgery and the intraoperative findings revealed an aortoesophageal fistula and necrotic materials with a foul
odor at the upper esophagus. Primary closure and wrapping of the aorta were performed, but primary closure of the
esophagus was impossible because of necrosis. An aortoesophageal fistula is a rare but life-threatening disease. As
shown for this patient, an exposed vessel without ulceration at the upper esophagus should raise suspicion of an
aortoesophageal fistula and a CT scan or angiography should be performed before endoscopic intervention.(Korean J Med
73:539-543, 2007) |
| Key Words:
Hematemesis, Aortoesophageal fistul |
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