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Stop exsanguination by inflation: management of aorta-esophageal fistula bleeding.
Pagano, Kristina M; Fokin, Alexander A; Parra, Michael; Puente, Ivan.
Afiliación
  • Pagano KM; Department of Surgery, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St AHC2, Miami, FL 33199, United States.
  • Fokin AA; Department of Trauma and Acute Care Surgery, Delray Medical Center, 5352 Linton Blvd, Delray Beach, FL 33484, United States.
  • Parra M; Department of Trauma and Acute Care Surgery, Broward County Health Care System, 1800 NW 49th Street, STE. 110, Fort Lauderdale, FL 33309, United States.
  • Puente I; Department of Trauma and Acute Care Surgery, Broward County Health Care System, 1800 NW 49th Street, STE. 110, Fort Lauderdale, FL 33309, United States.
J Surg Case Rep ; 2024(3): rjae120, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38463737
ABSTRACT
Aortoesophageal fistula is rare and typically presents itself to the emergency department as Chiari's Triad of mid-thoracic pain, sentinel arterial hemorrhage, and exsanguination after a symptom-free interval. However, fatal bleeding may be the first and last presentation of an aortoesophageal fistula. When a patient experiences massive hematemesis without witnesses, EMS may assume that bleed is of a traumatic mechanism. We present a case of a 59-year-old male with no previous medical history who was transported to a trauma center unconscious and with massive bleeding of unknown origin. Computed tomography revealed a thoracic aortic aneurysm and an aortoesophageal fistula. Bleeding was not controlled and the patient expired. Trauma bay personnel should follow an algorithm which includes a prompt tamponade of the bleed using a Sengstaken-Blakemore tube or esophageal balloon paralleled by massive transfusion and obtaining an early computed tomography scan to manage patients with massive gastroesophageal bleeding until appropriate surgical interventions can be initiated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Surg Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Surg Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido