Aortobronchial fistula after esophagectomy for esophageal cancer—A very rare complication

Most aorto-respiratory fistulas are related to aortic pathology or procedures, but fistula formation after esophageal resection has never been reported in the literature. We are now reporting a case of hemoptysis that occurred after esophagectomy for locally advanced esophageal cancer. Aortobronchial fistula was detected by computed tomography scan. The patient was finally saved by emergency surgery—Dacron graft interposition of the descending thoracic aorta. There was no malignant cell in the postoperative specimen of the fistula. The erosion of the ligaclips (Johnson & Johnson) might be responsible for the aortobronchial fistula formation. For esophageal surgery, avoidance of trauma to aortic wall and careful using of ligaclips are important to circumvent this complication.

摘要主動脈支氣管瘻管是一種罕見卻致命的疾病，通常是主動脈本身的病變或開心手術後的併發症，而發生於食道切除術後的主動脈支氣管瘻管則從未報告過。我們在此描述一位60歲男性的食道癌患者在接受食道切除術，因持續咳血經電腦斷層檢查後而發現主動脈支氣管瘻管，成功經由緊急開胸與降主動脈置換手術處理。術後的病理檢查並未發現瘻管處有復發的癌細胞。推測是食道癌手術中因血管夾引發的主動脈損傷造成之主動脈支氣管瘻管。在食道手術，避免主動脈壁的受損及小心使用血管夾乃避免此併發症發生的關鍵。