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J Korean Soc Emerg Med > Volume 28(5); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(5): 526-529.
Primary Aortoesophageal Fistula Presented as Massive Upper Gastrointestinal Bleeding
Chan Woo Park1, Taek Geun Ohk1, Jun Hwi Cho1, Joong Beom Moon1, Myung Chul Shin1, Ka Eul Kim1, Go Eun Yang2, Hui Young Lee3
1Department of Emergency Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
2Department of Radiology, Kangwon National University Hospital, Chuncheon, Korea
3Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
Correspondence  Taek Geun Ohk ,Tel: 033-258-2438, Fax: 033-258-2451, Email: otgotg11@gmail.com,
Received: May 12, 2017; Revised: May 16, 2017   Accepted: July 26, 2017.  Published online: October 31, 2017.
ABSTRACT
An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.
Key words: Aortic aneurysm, Thoracic, Esophageal fistula, Gastrointestinal hemorrhage
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