Esophageal perforation of aortic arch aneurysm treated free of mediastinitis without manipulating esophagus

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi
Yasunori ChoToshihiko Ueda

Abstract

Esophageal perforations of thoracic aortic aneurysms are most likely to be fatal. Patients with aortoesophageal fistula require urgent operation on both the esophageal perforation site and the aortic lesion to avoid terminal exsanguination and uncontrollable mediastinitis. We present a case of 71-year-old woman suffering esophageal perforation of aortic arch aneurysm with sentinel arterial hemorrhage, who has not developed patent aortoesophageal fistula. Computed tomography verified rupture of aortic arch aneurysm that had eroded the esophagus. She underwent successful graft replacement and remains well without signs of mediastinitis over one year after the event. It is possible, in selected cases of esophageal perforation of thoracic aortic aneurysm, to manage the esophageal lesion without any surgical intervention, such as primary closure, omental coverage and surgical discontinuity to achieve esophageal healing free of infection.

References

May 1, 1979·The Annals of Thoracic Surgery·J L CameronR R Baker
Jul 1, 1978·American Journal of Surgery·R CarterL A Brewer
Apr 25, 2002·Annals of Vascular Surgery·J R DuncanD G Gilmour

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Citations

Feb 28, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Francisco S LozanoJose Ramon Gonzalez-Porras
Jan 13, 2012·General Thoracic and Cardiovascular Surgery·Yutaka ImotoAkihiko Uchiyama
Mar 28, 2009·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Prachi P AgarwalElla A Kazerooni
May 26, 2012·Seminars in Ultrasound, CT, and MR·Robert LiottaPrachi P Agarwal

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