Aotric esophageal fistula: etiopathogenesis and diagnostics (review of literature)
https://doi.org/10.24884/0042-4625-2020-179-6-89-93
Abstract
Aortic esophageal fistula (AEF) is a rare but extremely life-threatening condition requiring immediate surgical treatment. The mortality rate among such patients may exceed 60 %, including after surgical treatment. Etiological and pathogenetic mechanisms of AEF are complex and various, but in most cases, they are associated with chronic aortic diseases. The second group of etiological factors of AEF includes trauma of esophagus wall by foreign bodies, malignant neoplasms of the esophagus or mediastinum. AEF may also occur as a result of surgical interventions on the aorta and esophagus. The difficulties of early diagnosis are primarily associated with non-specific clinical manifestations of AEF and the lack of unified protocol for the examination of patients with the first-time upper gastrointestinal tract bleeding. The described reasons in some cases can lead to an inaccurate diagnosis, which entails a loss of time. Among the instrumental diagnostic methods, the most informative is the combination of esophagogastroduodenoscopy and computed tomography of the chest with intravenous contrast enhancement. Each of these methods has its advantages and disadvantages, and allows to identify a number of direct and indirect signs of pathological communication between the aorta and the esophagus.
About the Authors
R. Sh. MuslimovRussian Federation
Muslimov Rustam Sh., Cand. of Sci. (Med.), Leading Research Fellow
3, Sukharevskaia pl., Moscow, 129090
Sh. N. Danielyan
Danielyan Shagen N., Dr. of Sci. (Med.), Leading Research Fellow
Moscow
I. E. Popova
Popova Irina E., Cand. of Sci. (Med.), Senior Research Fellow
Moscow
N. R. Chernaya
Chernaya Natalya R., Cand. of Sci. (Med.), Senior Research Fellow
Moscow
References
1. Rawala M. S., Badami V., Rizvi S. B., Nanjundappa A. Aortoesophageal Fistula: A Fatal Complication of Thoracic Endovascular Aortic StentGraft Placement. Am J Case Rep. 2018;(19):1258–1261. Doi: 10.12659/AJCR.911441.
2. Yang Y., Hu D., Peng D. Primary aortoesophageal fistula: A fatal outcome. Am J Emerg Med. 2018;36(2):343.e1–343.e3. Doi: 10.1016/j.ajem.2017.11.008.
3. Bergqvist D. Arterioenteric fistula. Review of a vascular emergency. Acta Chir Scand. 1987;153(2):81–86.
4. Hollander J. E., Quick G. Aortoesophageal fistula: a comprehensive review of the literature. Am J Med. 1991;91(3):279–287. Doi: 10.1016/00029343(91)90129l.
5. Mortensen A., Hansen N. F., Schiødt O. M. Fatal aortoesophageal fistula caused by button battery ingestion in a 1yearold child. Am J Emerg Med. 2010;28(8):984.e5–6. Doi: 10.1016/j.ajem.2010.01.007.
6. Muradi A., Yamaguchi M., Kitagawa A., Nomura Y., Okada T., Okita Y., Sugimoto K. Secondary aortoesophageal fistula after thoracic endovascular aortic repair for a huge aneurysm. Diagn Interv Radiol. 2013; 19(1):81–84. Doi: 10.4261/13053825.DIR.591212.1.
7. Dubrueil О. Observation sur la perforation de l’espphague et de l’aorte thoracique par une protion d’os oval: Avecdes reflexiones. J Univ Sci Med. 1818;(9):357–363.
8. Timen L. Ya. Klinikoendoskopicheskie nablyudeniya pervichnoi aortoezofageal’noi fistuly. Opisanie dvukh sluchaev. Russkii meditsinskii zhurnal. Meditsinskoe obozrenie. 2015;(17):1060. (In Russ.).
9. Akin M., Yalcinkaya T., Alkan E., Arslan G., Tuna Y., Yildirim B. A Cause of Mortal Massive Upper Gastrointestinal Bleeding: Aortoesophageal. Fistula. Med Arch. 2016;70(1):79–81. Doi: 10.5455/medarh.2016.70.7981.
10. Kokatnur L., Rudrappa M. Primary aortoesophageal fistula: Great masquerader of esophageal variceal bleeding. Indian J Crit Care Med. 2015; 19(2):119–121. Doi: 10.4103/09725229.151022.
11. Pham D., Nave J., Dhere T. Massive Gastrointestinal Bleeding due to an Aortoesophageal Fistula in a Patient with a Rightsided Aortic Arch after Nasogastric Tube Placement. American Journal of Gastroenterology. 2012;107(Suppl):S234.#564. Doi: 10.1038/ajg.2012.273.
12. Pitman M., Mocharla R., Villanueva G., Goodman A. Massive Gastrointestinal Hemorrhage From Aortoesophageal Fistula in a Patient With Congenital Double Aortic Arch. American Journal of Gastroenterology. 2017;112(Suppl):S909.
13. Wu M. H., Lai W. W. Aortoesophageal Fistula Induced by Foreign Bodies. Ann Thovac Surg. 1992;54(1):155–156. Doi: 10.1016/00034975(92)911689.
14. Cheng L. C., Chiu C. S. Foreign bodyinduced aortooesophageal fistula: a review of five cases and their management. Hong Kong Med J. 2006;12(3):219–221.
15. Kelly S., Peters P., Ogg M. J., Li A., Smithers B. M. Successful management of an aortoesophageal fistula caused by a fish bone – case report and review of literature. J Cardiothorac Surg. 2009;(4):21. Doi: 10.1186/17498090421.
16. Kieffer E., Chiche L., Gomes D. Aortoesophageal fistula: value of in situ aortic allograft replacement. Ann Surg. 2003 Aug;238(2):283–290. Doi: 10.1097/01.sla.0000080828.37493.e0.
17. Girdauskas E., Falk V., Kuntze T., Borger M. A., Schmidt A., Scheinert D., Mohr F. W. Secondary surgical procedures after endovascular stent grafting of the thoracic aorta: successful approaches to a challenging clinical problem. J Thorac Cardiovas Surg. 2008;136(5):1289–1294. Doi: 10.1016/j.jtcvs.2008.05.053.
18. Dumfarth J., Michel M., Schmidli J., Sodeck G., Ehrlich M., Grimm M. et al. Mechanisms of failure and outcome of secondary surgical interventions after thoracic endovascular aortic repair (TEVAR). Ann Thorac Surg. 2011;91(4):1141–1146. Doi: 10.1016/j.athoracsur.2010.12.033.
19. Tehrani H. Y., Peterson B. G., Katariya K., Morasch M. D., Stevens R., DiLuozzo G., Salerno T., Maurici G., Eton D., Eskandari M. K. Endovascular repair of thoracic aortic tears. Ann Thorac Surg. 2006; (82):873–877. Doi: 10.1016/j.athoracsur.2006.04.012.
20. Eggebrecht H., Baumgart D., Radecke K., von Birgelen C., Treichel U., Herold U. et al. Aortoesophageal fistula secondary to stentgraft repair of the thoracic aorta. J Endovasc Ther. 2004;11(2):161–170. Doi: 10.1583/031114.1.
21. Czerny M., Eggebrecht H., Sodeck G., Weigang E., Livi U., Verzini F. et al. New insights regarding the incidence, presentation and treatment options of aortooesophageal fistulation after thoracic endovascular aortic repair: the European Registry of Endovascular Aortic Repair Complications. Eur J Cardiothorac Surg. 2014;45(3):452–457. Doi: 10.1093/ejcts/ezt393.
22. Chiesa R., Melissano G., Marone E. M., MarroccoTrischitta M. M., Kahlberg A. Aortooesophageal and aortobronchial fistulae following thoracic endovascular aortic repair: a national survey. Eur J Vasc Endovasc Surg. 2010;39(3):273–279. Doi: 10.1016/j.ejvs.2009.12.007.
23. Sloop R. D., Thompson J. C. Aortoesophageal fistula: Report of a case and review of the literature. Gastroenterology. 1967;53(5):768–777.
24. Jiao Y., Zong Y., Yu Z. L., Yu Y. Z., Zhang S. T. Aortoesophageal fistula: a case misdiagnosed as esophageal polyp. World J Gastroenterol. 2009; 15(47):6007–6009. Doi: 10.3748/wjg.15.6007.
25. Chiari H. Ueber Fremdkorperverletzung des Oesophagus mit Aortenperforation. Berl Klin Wochenschr. 1914;(51):7–9.
26. Hakim S., Gjeorgjievski M., Garg L., Orosey M., Desai T. Atypical aortoesophageal fistula with atypical and delayed presentation and negative imaging studies. Case Rep Gastrointest Med. 2016;(2016):7219034. Doi: 10.1155/2016/7219034.
27. Roten R., Peterfy R. Aortoesophageal Fistula. Clin Pract Cases Emerg Med. 2017;1(3):260–261. Doi: 10.5811/cpcem.2017.2.33141.
28. Bokeriya L. A., Papitashvili V. G., Chigogidze N. A. Taktika otkrytykh i endovaskulyarnykh vmeshatel’stv pri anevrizmakh grudobryushnogo otdela aorty. Annaly khirurgii. 2012;(5):18–22. (In Russ.).
29. Arakelyan V., Gidaspov N. A., Papitashvili V. G. Redkie formy anevrizm dugi aorty. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2016;(4):16–25. (In Russ.). Doi: 10.2168816813472201641625.
30. Dumfarth J., Dejaco H., Krapf C., Schachner T., Wykypiel H., Schmid T. et al. AortoEsophageal Fistula After Thoracic Endovascular Aortic Repair: Successful Open Treatment. Aorta (Stamford). 2014;2(1):37–40. Doi: 10.12945/j.aorta.2014.13056.
Supplementary files
Review
For citations:
Muslimov R.Sh., Danielyan Sh.N., Popova I.E., Chernaya N.R. Aotric esophageal fistula: etiopathogenesis and diagnostics (review of literature). Grekov's Bulletin of Surgery. 2020;179(6):89-93. (In Russ.) https://doi.org/10.24884/0042-4625-2020-179-6-89-93