Erschienen in:
01.11.2003 | Case Report
Fatal Delayed Esophageal Rupture Following Aortic Clamping for
Treatment of Stanford Type B Dissection
verfasst von:
Hisao Ito, Takayuki Yamada, Tadashi Ishibashi, Masatoshi Akiyama, Takahiko Nakame, Yasuhiro Ito, Toshiaki Konnai
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 6/2003
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Abstract
A 65-year-old man underwent a thromboexclusion
operation for management of chronic Stanford type B dissecting aneurysm
in 1991. However, long-term follow-up CT scans after the operation
revealed that the ascending aorta gradually enlarged and was eventually
complicated by recurrent aortic dissection. The patient complained of
frequent bloody sputum, whereas chest roentogenography showed no
pulmonary abnormalities. Subsequent swallow esophagogram demonstrated
that the upper esophagus was deviated to the right and the middle
esophagus was greatly compressed by the aortic clamp. Esophageal
endoscopy showed a bloody inner surface and marked swelling of the
middle esophagus. The patient eventually died of massive hematemesis in 2001.
We describe the imaging features of unanticipated complications such as
recurrent dissecting aneurysm or impending esophageal rupture.
Furthermore, we discuss the cause of hematemesis and document that the
aortic clamp migrated and resulted in development of a recurrent
aneurysmal dissection, which in turn resulted in esophageal rupture
with aneurysmal disruption.