Aortoesophageal fistula: congenital and acquired causes

J Pediatr Surg. 1994 Sep;29(9):1212-4. doi: 10.1016/0022-3468(94)90803-6.

Abstract

Aortoesophageal fistula (AEF) is a rare but frequently lethal cause of upper gastrointestinal bleeding. This is a report of the authors' experience with four cases--two from congenital and two from acquired causes. A review of the pediatric cases reported in the literature is included. The mortality from AEF is high, and can be decreased in two ways. AEF can be prevented by avoiding prolonged nasogastric intubation in patients with known vascular rings, and by promptly removing esophageal foreign bodies and promptly treating periesophageal abscesses. Once an AEF occurs, it presents with typical large-herald upper gastrointestinal bleeding of bright red blood, and cardiovascular collapse. Recognition of this pattern, with vigorous resuscitation and aggressive surgical management, will improve the survival rate.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aortic Diseases / congenital*
  • Aortic Diseases / mortality
  • Aortic Diseases / surgery
  • Child, Preschool
  • Ductus Arteriosus, Patent / mortality
  • Ductus Arteriosus, Patent / surgery
  • Esophageal Fistula / congenital*
  • Esophageal Fistula / mortality
  • Esophageal Fistula / surgery
  • Esophagus / pathology
  • Esophagus / surgery
  • Extracorporeal Membrane Oxygenation
  • Fatal Outcome
  • Female
  • Fistula / congenital*
  • Fistula / mortality
  • Fistula / surgery
  • Foreign Bodies / mortality
  • Foreign Bodies / surgery
  • Gastrointestinal Hemorrhage / congenital*
  • Gastrointestinal Hemorrhage / mortality
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Iatrogenic Disease
  • Infant
  • Infant, Newborn
  • Male
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Resuscitation
  • Survival Rate