Pseudoaneurysm of the Descending Thoracic Aorta and Aorto-Oesophageal Fistula

  • Afrodīte Jankovska (Speaker)
  • Rems Zikovs (Co-author)
  • Aleksandrs Kagans (Co-author)
  • Ozoliņa, A. (Co-author)

Activity: Talk or presentation types › Poster presentation

Description

Aorto-esophageal fistula (AEF) is a rare but life-threatening cause of upper gastrointestinal bleeding associated with highly fatal conditions, regardless of the chosen treatment technique. A 74-year-old male on the 27th of July was admitted to the Riga East Clinical University Hospital (RAKUS) with increasing weakness and anemia. A patient refused further treatment and diagnosis and left the hospital. As the complaints progressed, the patient arrived at the Jurmala hospital, where anemia persisted. Upper Gastrointestinal endoscopy (EGD) was performed. An EGD showed no clinically significant pathology and the patient was discharged for ambulatory treatment. On the 31 of August patient was admitted to the RAKUS with hematemesis and melena. He presented with hypotension (62/30 mmHg). Laboratory results revealed a hemoglobin of 6,7 g/dL, erythrocytes 2.51x106 /μL, and reactive C protein of 114.0 mg/L. After therapy of norepinephrine and fluid resuscitation (S. Ringeri-Lac 500 ml), the patient recovered from the hemorrhagic shock. Based on symptoms, and previous results of the EGD a CT angiography of the chest and abdomen was performed. Conclusion - Descendent aortic pseudoaneurysm with a fistula to the esophagus. The council of doctors decided to start conservative therapy. The patient received transfusions of two red blood components, two FFP transfusions, vasopressor support (Norepinephrine), continuous IV infusions of tranexamic acid 2mg/kg/h, and Octaplex 1000 IU. On the 11th of September laboratory results revealed a Hb 9,8 g/dL and other results within a normal value. The patient was discharged from the hospital. Conclusion This case reports a successful strategy for the conservative treatment due to statistically adverse data of this treatment method. This indicates that there are no exact criteria for choosing a treatment strategy and it must be chosen individually for each patient.. .. .. .
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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