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Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report

BACKGROUND: Aortoesophageal fistula (AEF) induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat. Although the current view suggests that endovascular stent-graft treatment is useful for AEF, whether a subsequent thoracic operation is neces...

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Autores principales: Gong, Hang, Wei, Wei, Huang, Zhong, Hu, Ying, Liu, Xian-Li, Hu, Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8895182/
https://www.ncbi.nlm.nih.gov/pubmed/35321176
http://dx.doi.org/10.12998/wjcc.v10.i7.2206
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author Gong, Hang
Wei, Wei
Huang, Zhong
Hu, Ying
Liu, Xian-Li
Hu, Zhen
author_facet Gong, Hang
Wei, Wei
Huang, Zhong
Hu, Ying
Liu, Xian-Li
Hu, Zhen
author_sort Gong, Hang
collection PubMed
description BACKGROUND: Aortoesophageal fistula (AEF) induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat. Although the current view suggests that endovascular stent-graft treatment is useful for AEF, whether a subsequent thoracic operation is necessary remains controversial. The purpose of this report is to describe our experience using endovascular stent-graft treatment without combined thoracic operations for the treatment of AEF in two specific cases. CASE SUMMARY: We presented two cases of patients complaining of retrosternal discomfort treated in our department for an aortoesophageal fistula caused by the accidental ingestion of a fishbone. The two patients were effectively managed with combined means of endoscopic, medical (broad-spectrum antibiotic therapy, fasting, gastrointestinal decompression, etc.) and endovascular stent-graft treatment. The main difference in treatment was that the first patient presented with hematemesis after endoscopic removal of the fishbone. Subsequently, the patient underwent endovascular stent-graft treatment. The second case was managed with endoscopic removal of the fishbone with simultaneous endovascular stent-graft treatment, without any signs of hematemesis or melena. Both patients had successful postoperative management and were discharged home. Long-term follow-up is ongoing. CONCLUSION: The treatment decision-making process should depend on the patients’ specific situations. Our practice indicates that endovascular stent-graft treatment without combined thoracic operations could be a valuable alternative in selected patients.
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spelling pubmed-88951822022-03-22 Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report Gong, Hang Wei, Wei Huang, Zhong Hu, Ying Liu, Xian-Li Hu, Zhen World J Clin Cases Case Report BACKGROUND: Aortoesophageal fistula (AEF) induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat. Although the current view suggests that endovascular stent-graft treatment is useful for AEF, whether a subsequent thoracic operation is necessary remains controversial. The purpose of this report is to describe our experience using endovascular stent-graft treatment without combined thoracic operations for the treatment of AEF in two specific cases. CASE SUMMARY: We presented two cases of patients complaining of retrosternal discomfort treated in our department for an aortoesophageal fistula caused by the accidental ingestion of a fishbone. The two patients were effectively managed with combined means of endoscopic, medical (broad-spectrum antibiotic therapy, fasting, gastrointestinal decompression, etc.) and endovascular stent-graft treatment. The main difference in treatment was that the first patient presented with hematemesis after endoscopic removal of the fishbone. Subsequently, the patient underwent endovascular stent-graft treatment. The second case was managed with endoscopic removal of the fishbone with simultaneous endovascular stent-graft treatment, without any signs of hematemesis or melena. Both patients had successful postoperative management and were discharged home. Long-term follow-up is ongoing. CONCLUSION: The treatment decision-making process should depend on the patients’ specific situations. Our practice indicates that endovascular stent-graft treatment without combined thoracic operations could be a valuable alternative in selected patients. Baishideng Publishing Group Inc 2022-03-06 2022-03-06 /pmc/articles/PMC8895182/ /pubmed/35321176 http://dx.doi.org/10.12998/wjcc.v10.i7.2206 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Gong, Hang
Wei, Wei
Huang, Zhong
Hu, Ying
Liu, Xian-Li
Hu, Zhen
Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report
title Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report
title_full Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report
title_fullStr Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report
title_full_unstemmed Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report
title_short Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report
title_sort endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: two cases report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8895182/
https://www.ncbi.nlm.nih.gov/pubmed/35321176
http://dx.doi.org/10.12998/wjcc.v10.i7.2206
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