Aortoesophageal Fistula: A Life-Threatening Cause of Upper Gastrointestinal Hemorrhage in Double Aortic Arch, a Case Report
Arnkisa Chaikitpinyo MD*, Manat Panamonta MD*, Sumitr Sutra MD*, Cherdchai Tontisirin MD**, Jiraporn Srinakarin MD***, Yuttapong Wongswadiwat MD****
Affiliation : * Department of Pediatrics, Faculty of Medicine, Khon Kaen University ** Department of Surgery, Faculty of Medicine, Khon Kaen University *** Department of Radiology, Faculty of Medicine, Khon Kaen University **** Queen Sirikit Heart Center of the Northeast, Khon Kaen University
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 AEFand 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.
Keywords : Upper gastrointestinal hemorrhage, Aortoesophageal fistula, Double aortic arch
