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A date pit induced aorto-oesophageal fistula: a case report and concise literature review

Aorto-oesophageal fistula (AEF) is rare and fatal without intervention. Having consumed a date pit 2 weeks prior, the patient in this case presented with the ‘Chiari’ triad of chest pain, sentinel arterial upper gastro-intestinal haemorrhage and exsanguination after an asymptomatic interval. Followi...

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Autores principales: Lichtenstein, Kevin M, Russell, Thomas B, Lichtenstein, Julia B, Brar, Harinderpal S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885142/
https://www.ncbi.nlm.nih.gov/pubmed/33614050
http://dx.doi.org/10.1093/omcr/omaa140
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author Lichtenstein, Kevin M
Russell, Thomas B
Lichtenstein, Julia B
Brar, Harinderpal S
author_facet Lichtenstein, Kevin M
Russell, Thomas B
Lichtenstein, Julia B
Brar, Harinderpal S
author_sort Lichtenstein, Kevin M
collection PubMed
description Aorto-oesophageal fistula (AEF) is rare and fatal without intervention. Having consumed a date pit 2 weeks prior, the patient in this case presented with the ‘Chiari’ triad of chest pain, sentinel arterial upper gastro-intestinal haemorrhage and exsanguination after an asymptomatic interval. Following resuscitation, the patient was managed with a Blakemore tube with both oesophageal and gastric balloons inflated to systemic pressures. An aortic stent graft was planned but the patient died on the operating table. AEFs can be treated surgically with either open or endovascular repair. Open repair is highly risky and involves combined replacement/bypass of the thoracic aorta along with resection/repair of the involved oesophagus. Endovascular repair can prevent fatal exsanguination and increase the likelihood of survival but is associated with a significant rate of secondary infection, recurrence of fistula, mediastinitis and sepsis. Further studies are required to inform on management.
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spelling pubmed-78851422021-02-19 A date pit induced aorto-oesophageal fistula: a case report and concise literature review Lichtenstein, Kevin M Russell, Thomas B Lichtenstein, Julia B Brar, Harinderpal S Oxf Med Case Reports Case Report Aorto-oesophageal fistula (AEF) is rare and fatal without intervention. Having consumed a date pit 2 weeks prior, the patient in this case presented with the ‘Chiari’ triad of chest pain, sentinel arterial upper gastro-intestinal haemorrhage and exsanguination after an asymptomatic interval. Following resuscitation, the patient was managed with a Blakemore tube with both oesophageal and gastric balloons inflated to systemic pressures. An aortic stent graft was planned but the patient died on the operating table. AEFs can be treated surgically with either open or endovascular repair. Open repair is highly risky and involves combined replacement/bypass of the thoracic aorta along with resection/repair of the involved oesophagus. Endovascular repair can prevent fatal exsanguination and increase the likelihood of survival but is associated with a significant rate of secondary infection, recurrence of fistula, mediastinitis and sepsis. Further studies are required to inform on management. Oxford University Press 2021-02-15 /pmc/articles/PMC7885142/ /pubmed/33614050 http://dx.doi.org/10.1093/omcr/omaa140 Text en © The Author(s) 2021. Published by Oxford University Press. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lichtenstein, Kevin M
Russell, Thomas B
Lichtenstein, Julia B
Brar, Harinderpal S
A date pit induced aorto-oesophageal fistula: a case report and concise literature review
title A date pit induced aorto-oesophageal fistula: a case report and concise literature review
title_full A date pit induced aorto-oesophageal fistula: a case report and concise literature review
title_fullStr A date pit induced aorto-oesophageal fistula: a case report and concise literature review
title_full_unstemmed A date pit induced aorto-oesophageal fistula: a case report and concise literature review
title_short A date pit induced aorto-oesophageal fistula: a case report and concise literature review
title_sort date pit induced aorto-oesophageal fistula: a case report and concise literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885142/
https://www.ncbi.nlm.nih.gov/pubmed/33614050
http://dx.doi.org/10.1093/omcr/omaa140
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