Document Detail

Fatal aortoesophageal fistula in two cases of tight vascular ring.
MedLine Citation:
PMID:  12018723     Owner:  NLM     Status:  MEDLINE    
Vascular rings are rare vascular congenital anomalies causing oesophageal and tracheal compression. An aortoesophageal fistula is a devastating, in part iatrogenic, complication of vascular rings. It is seen with increasing frequency, and can be misleading, since differential diagnosis with other causes of haematemesis and melaena is often difficult, especially in infants. We report two infants with aortoesophageal fistulas secondary to double aortic arches forming a vascular ring. In both, the diagnosis was missed, and massive haemorrhage led to death. In both cases, the fissuration on the oesophageal and aortic sides of the fistula had sharp edges, highly suggestive of an iatrogenic laceration caused by manipulation of nasogastric tubes. The key for the diagnosis of vascular rings is, therefore, clinical suspicion and awareness of this condition. Prompt identification in infants with stridor, wheezing, or respiratory distress can prevent prolonged intubation, thus avoiding the formation of an aortoesophageal fistula and hopefully preventing a fatal outcome.
Annalisa Angelini; Konstantinos Dimopoulos; Carla Frescura; Piergiorgio Gamba; Roberto Lo Piccolo; Giovanni Stellin; Gaetano Thiene
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cardiology in the young     Volume:  12     ISSN:  1047-9511     ISO Abbreviation:  Cardiol Young     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-05-20     Completed Date:  2002-11-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  172-6     Citation Subset:  IM    
Department of Pathology, University of Padua Medical School, Italy.
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MeSH Terms
Aorta, Thoracic / abnormalities*,  surgery
Aortic Diseases / diagnosis
Cardiac Surgical Procedures / methods
Esophageal Diseases / diagnosis
Esophageal Fistula / diagnosis*
Fatal Outcome
Heart Catheterization
Heart Septal Defects, Ventricular / diagnosis,  surgery*
Risk Assessment
Severity of Illness Index
Vascular Fistula / diagnosis*

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