Aortoesophageal fistula: a life-threatening cause of upper gastrointestinal hemorrhage in double aortic arch, a case report
Chaikitpinyo, A.; Panamonta, M.; Sutra, S.; Tontisirin, C.; Srinakarin, J.; Wongswadiwat, Y.
Journal of the Medical Association of Thailand 87(8): 992-995
2004
ISSN/ISBN: 0125-2208 PMID: 15471308 Document Number: 2125
The authors present the case of a 2 -month- old infant with double aortic arch that developed massive bright red upper gastrointestinal hemorrhage from aortoesophageal fistula (AEF) after prolonged endotracheal and nasogastric intubation. Emergency thoracotomy with AEF and double aortic arch repaired were done successfully under cardiopulmonary bypass. Due to tracheomalacia and left phrenic nerve injury, tracheal extubation could not be done until 1 month after correction of the vascular ring. The endotracheal and nasogastric tube led to fistula formation by compression of the esophageal wall against an abnormal double aortic arch. When a double aortic arch is suspected, prolonged nasogastric intubation should be avoided.
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