Dieulafoy양 병변으로 발현된 대동맥식도루 1예
A case of an aortoesophageal fistula presenting as a Dieulafoy-like lesion
김대진, 정윤진, 이주영, 이완석, 이현철, 정민규, 전성우,
소속 상세정보
김대진 ( Kim Dae-Jin )
경북대학교 의과대학 내과학교실
정윤진 ( Chung Yun-Jin )
경북대학교 의과대학 내과학교실
이주영 ( Lee Ju-Young )
경북대학교 의과대학 내과학교실
이완석 ( Lee Wan-Suk )
경북대학교 의과대학 내과학교실
이현철 ( Lee Hyun-Chul )
경북대학교병원 소화기내과
정민규 ( Jung Min-Kyu )
경북대학교 의과대학 내과학교실
전성우 ( Jeon Seong-Woo )
경북대학교 의과대학 내과학교실
KMID : 0882420070730050539
Abstract
A 68-year-old woman visited our emergency center because of hematemesis. An emergency endoscopy showed an exposed vessel with blood flowing into the upper esophagus. Angiography revealed the presence of extravasation of contrast at the level of the aortic arch and a tortuous fistula between the aortic arch and esophagus. Chest computerized tomography demonstrated the presence of an aortoesophageal fistula and air bubbles inside the fistula. The patient had emergency surgery and the intraoperative findings revealed an aortoesophageal fistula and necrotic materials with a foul odor at the upper esophagus. Primary closure and wrapping of the aorta were performed, but primary closure of the esophagus was impossible because of necrosis. An aortoesophageal fistula is a rare but life-threatening disease. As shown for this patient, an exposed vessel without ulceration at the upper esophagus should raise suspicion of an aortoesophageal fistula and a CT scan or angiography should be performed before endoscopic intervention.
키워드
Hematemesis; Aortoesophageal fistula
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