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Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding
Aorto-esophageal fistula is a rare cause of upper gastrointestinal bleeding. Thoracic aneurysm, the most common cause of this condition, will slowly increase over time and can erode the wall of the aorta creating a fistula and leading to torrential bleeding. High clinical suspicion is required for t...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339898/ https://www.ncbi.nlm.nih.gov/pubmed/25722556 http://dx.doi.org/10.4103/0972-5229.151022 |
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author | Kokatnur, Laxmi Rudrappa, Mohan |
author_facet | Kokatnur, Laxmi Rudrappa, Mohan |
author_sort | Kokatnur, Laxmi |
collection | PubMed |
description | Aorto-esophageal fistula is a rare cause of upper gastrointestinal bleeding. Thoracic aneurysm, the most common cause of this condition, will slowly increase over time and can erode the wall of the aorta creating a fistula and leading to torrential bleeding. High clinical suspicion is required for timely diagnosis as common investigations routinely done for gastrointestinal (GI) bleeding, including esophagogastroduodenoscopy, fails to detect most cases. The classical triad of midthoracic pain, herald bleeding and fatal hematemesis described in this condition is seen in only one-third of cases. Physician should be wary of this condition, especially in elderly patients with uncontrolled GI bleeding and who are also at risk of thoracic aneurysm. Computed tomography angiogram detects most cases and emergent endovascular repair with stents controls the initial bleeding. Later, both the aorta and the esophagus are repaired and reconstructed in staged procedures. |
format | Online Article Text |
id | pubmed-4339898 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-43398982015-02-26 Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding Kokatnur, Laxmi Rudrappa, Mohan Indian J Crit Care Med Case Report Aorto-esophageal fistula is a rare cause of upper gastrointestinal bleeding. Thoracic aneurysm, the most common cause of this condition, will slowly increase over time and can erode the wall of the aorta creating a fistula and leading to torrential bleeding. High clinical suspicion is required for timely diagnosis as common investigations routinely done for gastrointestinal (GI) bleeding, including esophagogastroduodenoscopy, fails to detect most cases. The classical triad of midthoracic pain, herald bleeding and fatal hematemesis described in this condition is seen in only one-third of cases. Physician should be wary of this condition, especially in elderly patients with uncontrolled GI bleeding and who are also at risk of thoracic aneurysm. Computed tomography angiogram detects most cases and emergent endovascular repair with stents controls the initial bleeding. Later, both the aorta and the esophagus are repaired and reconstructed in staged procedures. Medknow Publications & Media Pvt Ltd 2015-02 /pmc/articles/PMC4339898/ /pubmed/25722556 http://dx.doi.org/10.4103/0972-5229.151022 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Kokatnur, Laxmi Rudrappa, Mohan Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding |
title | Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding |
title_full | Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding |
title_fullStr | Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding |
title_full_unstemmed | Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding |
title_short | Primary aorto-esophageal fistula: Great masquerader of esophageal variceal bleeding |
title_sort | primary aorto-esophageal fistula: great masquerader of esophageal variceal bleeding |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339898/ https://www.ncbi.nlm.nih.gov/pubmed/25722556 http://dx.doi.org/10.4103/0972-5229.151022 |
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