1/3. Aortobronchial fistula: a rare etiology for hemoptysis.Aortobronchial fistula is an extremely rare cause of hemoptysis. Aortobronchial fistula occurs in patients who have a history of thoracic vascular surgery. Because its symptoms are nonspecific, a high index of suspicion is critical if the physician is to detect it. The results of imaging studies (e.g., plain films, computed tomography, and angiography) and bronchoscopy are sometimes, but not always, diagnostic--another reason the diagnosis is difficult. Left untreated, mortality in patients with aortobronchial fistula is 100%. patients can be salvaged by a variety of techniques, including the placement of an endovascular stent. We describe the case of a 52-year-old man who came to us with hoarseness and hemoptysis, which proved to be underlying symptoms of aortobronchial fistula. He was treated successfully.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/3. Secondary aortoduodenal fistula.Secondary aortoenteric fistula (SAF) is now recognized as an uncommon but exceedingly important complication of abdominal aortic reconstruction. The complication often occurs months to years after the original surgery. The main clinical manifestation of the disease is always upper gastrointestinal bleeding. Treatment of the disease is early surgical intervention. The mortality is high if no prompt operation. We present a case of secondary aortoduodenal fistula (SADF) found 20 days after aortic reconstructive surgery, with the clinical presentation of upper gastrointestinal bleeding. Even immediate exploratory laparotomy was performed, the patient died 48 hrs after the surgical management. Because of the increasing number of elective aortic aneurysm repairs in the aging population, it is likely that more patients with SAF will present to the clinical physicians in the future. So, a high index of suspicion is necessary for prompt diagnosis and treatment of this actually life-threatening event.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/3. Dysphagia aortica: a neglected symptom of aortoesophageal fistula.Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncommon cause of gastrointestinal bleeding that is uniformly fatal without surgical intervention. Typical symptoms are midthoracic pain and/or dysphagia followed by a usually short, albeit unpredictable, symptom-free interval and by a 'herald' haemorrhage, which is observed in 80% of patients before fatal exsanguinations. Dysphagia is present in 45% of patients, sometimes for several weeks, before the first bleeding occurs. However, dysphagia aortica is rarely considered in the differential diagnosis of dysphagia and lack of awareness, as well as symptom's underevaluation, both contribute to a significant diagnostic and therapeutic delay. We present a case of a 77-year-old woman who died for a bleeding AEF consequent to a thoracic aortic aneurysm and whose main symptom during the past 2 months was dysphagia, which was not taken seriously into consideration by her general practitioner. This case report emphasises that primary care physicians should be alerted to evaluate carefully the alarming symptoms like dysphagia -- especially in elderly patients -- before life threatening complications occur, as they are the ones who could suspect early the diagnosis and make a proper referral.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |