Clinical presentation and staged multidisciplinary management of aortoesophageal fistula.

PURPOSES: To describe the clinical presentation, staged management strategies, and the outcomes of patients with aortoesophageal fistula (AEF) in a single-center institutional series.

METHODS

We retrospectively reviewed confirmed AEF cases treated at our institution between 2009 and 2023. The cases were described according to etiology, clinical presentation, baseline severity, prior aortic intervention, treatment pathway, and outcomes.

RESULTS

Eighteen patients were included: 13 with primary AEF and 5 with secondary post-TEVAR. The most frequent presenting symptoms were hematemesis, often accompanied by chest pain, melena, or fever. Contrast-enhanced CT or computed tomography angiography (CTA) is the primary diagnostic modality. TEVAR is frequently used as an initial strategy for hemorrhage control. Multidisciplinary management, including operative control, anti-infective therapy, and nutritional support, is commonly used to manage these patients.

CONCLUSIONS

In our cohort, CTA was commonly used as the primary diagnostic modality for suspected AEF, and TEVAR was the initial strategy for hemorrhage control. Management in this cohort often involved staged multidisciplinary coordination, focusing on hemostasis, infection control, and delayed reconstruction. These findings should be interpreted as descriptive and hypothesis-generating.