RESUMO
Aortoesophageal fistula induced by atherosclerotic thoracic aortic aneurysm is rare, but is usually a fatal disorder, with few survivors reported. We report the case of a 72-year-old man with aortoesophageal fistula successfully treated in a two-stage operation. In the first stage, we performed resection and replacement of the aortic aneurysm with a prosthetic graft in situ, esophagectomy, cervical esophagostomy, and jejunostomy. After the patient recovered well postoperatively, a transmediastinal retrosternal interposition of the stomach was performed, with esophagogastroanastomosis in the cervical area, to re-establish the gastrointestinal tract. We include a discussion of the causes, diagnostic approach, management of the aorta and esophagus, and review of the literature.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Fístula Esofágica/cirurgia , Fístula Vascular/cirurgia , Idoso , Anastomose Cirúrgica , Aneurisma da Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Implante de Prótese Vascular , Fístula Esofágica/diagnóstico por imagem , Esofagectomia , Esofagostomia , Humanos , Jejunostomia , Masculino , Reoperação , Tomografia Computadorizada por Raios X , Fístula Vascular/diagnóstico por imagemRESUMO
We report three cases of Periarteritis Nodosa and review the related bibliography. Some considerations are made on P. A. N. varieties: sistemic or classic type and cutaneous type.