Year 2021 / Volume 113 / Number 9
Letter
Massive upper gastrointestinal bleeding secondary to an esophago-arterial fistula (arteria lusoria)

687

DOI: 10.17235/reed.2021.7811/2021

Eduardo Valdivielso Cortázar, Andrea Guerro Moya, Pedro Alonso Aguirre,

Abstract
A 50-year-old patient with a history of hypopharyngeal cancer, laryngectomy, adjuvant chemoradiotherapy and incompetent tracheoesophageal fistula was admitted for elective pharingostomal surgery. During the surgery, he presented esophageal bleeding with hemodynamic instability. After stabilization, a gastroscopy was performed through the stoma, showing arterial bleeding 4-5 cm distal to the stoma, which was controlled with three hemostatic clips. After four hours, the patient presented a new episode of bleeding with hemodynamic instability and a Sengstaken-Blakemore tube was placed that stopped the bleeding. Computed tomography angiography (CT angiography) was performed, which showed an aberrant right subclavian artery with a retroesophageal pathway, in close contact with the area where the clips were placed. An endovascular stent was placed in the right subclavian artery with control of the bleeding after removal of the Sengstaken-Blakemore tube. The patient was discharged seven days later.
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References
1) Malz G, Burri B. Aberrant subclavian artery (arteria lusoria): sex differences in the prevalence of various forms of the malformation. Evaluation of 1378 observations. Virchows Arch A Pathol Anat Histol 1978;380:303-15
2) Fernández-Álvarez P, Valladolid-León JM, Caunedo Álvarez A. Compresión esofágica por estructura vascular mediastínica como causa de disfagia lusoria. Rev Esp Enferm Dig 2020;112:505
3) Shires CB, Rohrer MJ. Anomalous Right Subclavian Artery- Esophageal Fistulae. Case Rep in Vasc Med 2018;7541904.
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Citation tools
Valdivielso Cortázar E, Guerro Moya A, Alonso Aguirre P. Massive upper gastrointestinal bleeding secondary to an esophago-arterial fistula (arteria lusoria). 7811/2021


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Publication history

Received: 20/01/2021

Accepted: 28/01/2021

Online First: 11/02/2021

Published: 07/09/2021

Article revision time: 5 days

Article Online First time: 22 days

Article editing time: 230 days


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