Intractable esophago-mediastinal fistula as a rare complication following thoracoabdominal aortic replacement

Takeyuki Wada, Hiroya Takeuchi, Naoki Fujimura, Rieko Nakamura, Takashi Oyama, Tsunehiro Takahashi, Norihito Wada, Yoshirou Saikawa, Hideyuki Shimizu, Ryohei Yozu, Yuko Kitagawa

Research output: Contribution to journalArticlepeer-review


Although occurring infrequently, esophagomediastinal fistula is potentially life-threatening.Wereport a rare case of intractable esophago-mediastinal fistula following thoracoabdominal aortic replacement. A 62-year-old male patient with aortic dissection underwent thoracoabdominal aortic replacement. He suddenly developed septic shock with esophageal perforation on the 6th postoperative day. Conservative therapy was employed, and he was discharged from the hospital. However, he suffered another attack of septic shock resulting from an esophago-mediastinal fistula. Gastrointestinal endoscopy revealed a suture thread beside an esophageal fistula. The patient consequently underwent esophagectomy. After removal of the esophagus, we found a suture thread with pledgets in the mediastinum and removed it. He recovered successfully thereafter. Esophago-mediastinal fistula associated with pledgets is a rare complication of thoracoabdominal aortic replacement. We believe that radical surgery can be an effective treatment. A review of the current literature did not reveal any similar cases. In this report, we discuss the clinical course of such a rare case.

Original languageEnglish
Pages (from-to)277-281
Number of pages5
Issue number4
Publication statusPublished - 2011 Dec 1


  • Aortic aneurysm
  • Esophageal fistula
  • Esophagectomy

ASJC Scopus subject areas

  • Gastroenterology


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