Year 2021 / Volume 113 / Number 9
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Year 2021 / Volume 113 / Number 9

Letter

Massive upper gastrointestinal bleeding secondary to an esophago-arterial fistula (arteria lusoria)

687

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

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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Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
© 2021 The Spanish Journal of Gastroenterology