Frontiers in cardiovascular medicine · 2026
Case Report: Aortoesophageal Fistula induced by a fish bone: the critical role of mediastinal infection control after TEVAR and endoscopic closure.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ma Yue, Zhang Lin, Ji Fucheng
Аннотация
BACKGROUND: Foreign-body-related aortoesophageal fistula (AEF) is rare and fatal without rapid hemostasis and infection control.
CASE: A 74-year-old woman presented with hematemesis and shock after suspected fish-bone ingestion. Emergency TEVAR with a 32 mm covered stent-graft (proximal landing in the distal third of the left subclavian artery) controlled bleeding. Endoscopic clip-and-line closure of an approximately 15 mm esophageal defect was performed. Despite broad-spectrum antimicrobial therapy, the patient developed recurrent fever and later rebleeding associated with mediastinal sepsis.
CONCLUSION: TEVAR and endoscopic repair require an integrated, early source-control strategy. A stepwise algorithm prioritizing timely mediastinal drainage is essential to prevent graft contamination, infectious relapse, and rebleeding.
CASE: A 74-year-old woman presented with hematemesis and shock after suspected fish-bone ingestion. Emergency TEVAR with a 32 mm covered stent-graft (proximal landing in the distal third of the left subclavian artery) controlled bleeding. Endoscopic clip-and-line closure of an approximately 15 mm esophageal defect was performed. Despite broad-spectrum antimicrobial therapy, the patient developed recurrent fever and later rebleeding associated with mediastinal sepsis.
CONCLUSION: TEVAR and endoscopic repair require an integrated, early source-control strategy. A stepwise algorithm prioritizing timely mediastinal drainage is essential to prevent graft contamination, infectious relapse, and rebleeding.