Ruptured Aortic Aneurysm Esophageal Fistula

Abstract

It has been estimated that 10% of ruptures of thoracic aortic aneurysm present as aortoesophageal fistula. They can present with mild esophageal bleeding giving warning of a fistula formation or as torrential exsanguinating hemorrhage. It is during the window of mild esophageal bleeding where it is possible to salvage the situation with prompt diagnosis and emergency surgical treatment. Once exsanguinating hemorrhage occurs, most patients are beyond salvage. We describe a patient who has torrential hemorrhage from an aortoesophageal fistula from a ruptured thoracic aneurysm. The hemorrhage was controlled promptly by the Sengstaken-Blakemore balloon compression tube (Willy-Rusch Ag, Kernen, Germany), which allowed stabilization of the patient's condition before definitive surgery was undertaken.