인문학
사회과학
자연과학
공학
의약학
농수해양학
예술체육학
복합학
DBpia AI
AI 에이전트
AI 아이디어
AI 리더
AI 뷰어
Citeasy
크롬 서지관리 다운로드
지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록·키워드
Aortoesophageal fistula (AEF) is a rare but life-threatening condition. Initial management typically includes thoracic endovascular aortic repair (TEVAR) or aortic graft replacement to achieve hemostasis, followed by esophagectomy with aortic graft replacement and greater omentum wrapping to eliminate the source of infection. We report a case of successful endoscopic closure of a chronic esophageal fistula secondary to AEF. A 63-year-old man presented with hematemesis. He had a history of two ascending aortic replacements and one descending aortic replacement for aortic dissection. Computed tomography revealed a pseudoaneurysm at the graft anastomosis site and perforation into the esophagus. He was diagnosed with AEF and underwent TEVAR for hemostasis. Although the bleeding was stopped, follow-up imaging confirmed a residual fistula. Because of his poor general condition, surgery was contraindicated, and endoscopic closure was attempted. Initial treatment with hemostasis clips was ineffective. A second attempt using polyglycolic acid sheets, fibrin glue, and hemostasis clips with endoscopic submucosal dissection (ESD) achieved closure, but the fistula reopened after 5 months. Finally, the combination of ESD and over-the-scope clip (OTSC) achieved complete and sustained closure. The patient was discharged after 3 months but died 8 months postoperatively owing to idiopathic splenic rupture. This case demonstrates that the combination of ESD and OTSC may be an effective treatment option for chronic esophageal fistulas caused by AEF.
인공지능 문자 인식 모델을 통해 추출된 텍스트로, 일부 오타나 오류가 포함될 수 있으나 지속적으로 개선 중입니다.
오류를 발견하셨다면 해당 부분을 드래그한 후 ' 를 통해 신고해주세요.
오류를 발견하셨다면 해당 부분을 드래그한 후 ' 를 통해 신고해주세요.
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