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Primary aortoesophageal fistula from aortic aneurysm: Successful surgical treatment by use of omental pedicle graft  Joseph S. Coselli, MD, E.Stanley.

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Presentation on theme: "Primary aortoesophageal fistula from aortic aneurysm: Successful surgical treatment by use of omental pedicle graft  Joseph S. Coselli, MD, E.Stanley."— Presentation transcript:

1 Primary aortoesophageal fistula from aortic aneurysm: Successful surgical treatment by use of omental pedicle graft  Joseph S. Coselli, MD, E.Stanley Crawford, MD  Journal of Vascular Surgery  Volume 12, Issue 3, Pages (September 1990) DOI: / (90) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Computerized thoracic tomography of the chest at the level of the distal aortic arch and proximal descending aorta. Note the presence of aortic aneurysm with contained mediastinal rupture (F) displacing the trachea (T) and esophagus (arrow) anteriorly away From the spine. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Preoperative aortogram and drawing demonstrates chronic dissection and aneurysm of the descending thoracic aorta with contained rupture and erosion into the thoracic esophagus. Note the presence of previous ascending aortic graft, aortobilateral iliac graft, and size of aorta at the level of the visceral arteries. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 Artistic rendition of ruptured false lumen of the proximal descending thoracic aorta into the mediastinum with anterior displacement and erosion of the esophageal wall with rupture into its lumen. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 4 Drawing of operative repair, including Dacron tube graft replacement of descending thoracic aortic aneurysm with primary repair of the esophageal rupture site, mobilization of the greater omental pedicle graft into the thorax to reinforce esophageal suture line. Postoperative barium swallow demonstrates intact esophageal repair and gastrointestinal continuity. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 5 Postoperative CT scan of the chest demonstrates position of omental pedicle flap (O) between aortic graft (G) and esophagus (arrow). Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

7 Fig. 6 CT scan of the upper abdomen shows marked enlargement of the upper abdominal aorta. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

8 Fig. 7 Postoperative aortogram and drawing demonstrates graft repair of descending thoracic aortic aneurysm. Note the development of aneurysm at the level of the aortic visceral arterial segment immediately proximal to infrarenal aortic graft. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

9 Fig. 8 Postoperative arteriography and drawing after graft replacement of thoracoabdominal aorta, reattachment of intercostal arteries, visceral arteries, and interposition graft to the left renal artery. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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