Fatal Aorto-Esophageal Fistula Bleeding due to Previous Esophageal Ulcer: Report of a Case

食道潰瘍併發致命的動脈食道瘻管出血：一病例報告

鄭群翰(Chun-Han Cheng) ； 陳銘仁(Ming-Jen Chen) ； 王鴻源(Horng-Yuan Wang):施壽全(Shou-Chuan Shih) ； 陳志仁(Chih-Jen Chen)

《臺灣消化醫學雜誌》 30卷4期 (2013/12) Pp. 309-313

https://doi.org/10.6557/GJT.201312_30(4).0003

摘要

動脈食道瘻管是個罕見但具有災難性的疾病，易造成致命的大量上消化道出血，且在接受手術前常常無法確診。動脈食道瘻管造成的原因通常是動脈瘤、手術後、放射線治療、或食道腫瘤。84歲女性因為先前食道潰瘍形成動脈食道瘻管而大量吐血。經過上消化道內視鏡、電腦斷層及血管攝影而確診。接受緊急動脈血管內支架置放術後達到初步的止血，但病人因多重器官衰竭而在一天後過世。動脈食道瘻管患者的預後取決於大量出血前的早期介入治療。必須具備高度的警覺心才能早期診斷，以期增加患者存活的機會。

關鍵字

食道 ； 瘻管 ； 異物 ； 出血 ； 死亡率

並列摘要

Aorto-esophageal fistula is rare and frequently missed preoperatively, while catastrophic condition usually occurs in the event of massive upper gastrointestinal hemorrhage. Aorto-esophageal fistulas are generally caused by an aortic aneurysm, a previous operation, radiotherapy, or esophageal tumor. An 84-year-old woman suffered massive hematemesis from an aorto-esophageal fistula due to a previous esophageal ulcer. The diagnosis was confirmed by esophagogastroduodenoscopy, computed tomography, and angiography. An emergent aorta endovascular stent insertion was performed with initial hemostasis, but she died one day later due to multiple organ failure. Clinical outcome of aorto-esophageal fistula depends on early intervention before massive hemorrhage occurs. A high index of suspicion is needed for early diagnosis, which may improve the chance of survival.

並列關鍵字

esophagus ； fistula ； foreign bodies ； hemorrhage ； mortality