PDF(Pubmed)
Abstract：
Aortoesophageal fistula (AEF) is a rare cause of upper gastrointestinal bleeding that often receives little attention in the emergency department. The classic presentation includes the Chiari triad of central chest pain, sentinel arterial bleeding, and subsequent evacuation after an asymptomatic period. For patients suspected of having AEF, a CT scan with IV contrast is the preferred diagnostic modality. In our patient, the presence of an aortic wall outpouching, ectopic gas, periaortic fat stranding, and leukocytosis, even in the absence of fever and positive blood culture, suggested mycotic aneurysm with AEF. The unique aspect of this case report is the occurrence of AEF as a rare complication of endoscopic procedures, which should be considered. Treatment options for AEF include surgery and thoracic endovascular aortic repair (TEVAR). TEVAR is a good option for stabilizing the patient\'s condition and reducing mortality in the short term. Once the patient\'s condition is suitable for AEF repair surgery, surgical intervention can be performed.
摘要：
主动脉食管瘘（AEF）是上消化道出血的罕见原因，在急诊科通常很少受到关注。经典的演讲包括Chiari三合会的中央胸痛，前哨动脉出血,以及无症状期后的疏散。对于怀疑患有AEF的患者，静脉造影CT扫描是首选的诊断方式.在我们的病人身上，主动脉壁的存在，异位气体,主动脉周围脂肪绞合，和白细胞增多，即使没有发烧和血培养阳性，提示有AEF的霉菌性动脉瘤。该病例报告的独特之处在于AEF是内镜手术的罕见并发症。这是应该考虑的。AEF的治疗选择包括手术和胸主动脉腔内修复术(TEVAR)。TEVAR是在短期内稳定患者病情和降低死亡率的良好选择。一旦患者的病情适合进行AEF修复手术，可以进行手术干预。
