Novosti
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This journal is indexed in Scopus |
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Year 2022 Vol. 30 No 5
CASE REPORTS
.N. BELYAEV 1, S.P. GRACHEV 2
A CASE OF AORTO-ESOPHAGEAL FISTULA MASKED WITH MALLORY-WEISS SYNDROME
National Research Mordovian State University named after N.P. Ogareva 1,
Mordovian Republican Central Clinical Hospital 2, Saransk,
Russian Federation
A clinical case of aorto-esophageal fistula in a 55-year-old patient, who was repeatedly operated due to massive gastrointestinal bleeding with intra-operative finding of cardiac mucosal lacerations and massive thrombus has been described. The last episode of massive bleeding was complicated by severe hemorrhagic shock, intraoperative cardiac arrest and fatal outcome. Autopsy identified an aorto-esophageal fistula due to perforation of the esophagus by a fish bone. In this case, the typical anamnesis with intraoperative identification of cardiac esophageal mucosal ruptures did not arouse any doubt about the Mallory-Weiss syndrome diagnosis. However, the discrepancy between the severity of bleeding and detected small lacerations of esophageal and gastric mucosa, episodes of repeated massive bleeding, scarlet blood leakage from the cardiac area of the stomach and esophagus should be suggested a possibility of other source of bleeding. Fishbone and esophageal perforation were not detected during gastroesophageal endoscopy, most likely due to massive blood clots. Esophageal perforation with formation of aorto-esophageal fistula is extremely rare and is accompanied by high mortality due to profuse bleeding. The treatment of aorto-esophageal fistulas is very complex and there are no clear recommendations. In most cases, it requires interdisciplinary collaboration of cardiothoracic and general surgeons for hybrid procedures to repair esophageal and aortic lesions.
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430013, Republic of Mordovia,
Saransk, Pobeda st., 14/5, 1,
Department of General Surgery
named after Professor N.I. Atyasov,
tel.: +79876933217,
e-mail: belyaevan@mail.ru,
Belyaev Alexander N.
Belyaev Alexandr N., MD, Professor, Head of the Department of Department of General Surgery named after Professor N.I. Atyasov National Research Mordovia State University.
https://orcid.org/0000-0002-0698-3007
Grachev Sergey P., PhD, Head of the Department of Clean Surgery, Mordovian Republican Central Clinical Hospital, Saransk, Russian Federation.
https://orcid.org/0000-0002-2397-5885
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