Fatal bleeding in a 1.5-year-old child with aortoesophageal fistula: case report and review of the literature

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Abstract

Aortoesophageal fistula in children is a very uncommon disease, which in most cases leads to death during the first days from the moment it occurs. Its high mortality is due to the lack of knowledge among doctors about the similarity of the disease in children and the lack of experience treating it. This paper presents the case history of a 1.5-year-old child who was admitted with bleeding from the upper gastrointestinal tract and died 36 hours after admission due to continued massive bleeding at the diagnostic measure stages. An autopsy revealed an aortic aneurysm with a diameter of 1.5 cm, which penetrated the esophageal lumen and formed an aortoesophageal fistula. This article analyzes the treatment results of 17 cases of successfully treating children with aortoesophageal fistula, which we found in the literature. It describes the leading causes and mechanisms of the development of this pathology in children. Also, the article describes the diagnostic and treatment methods for children with aortoesophageal fistula.

About the authors

Saidkhassan M. Bataev

Pirogov Russian National Research Medical University

Author for correspondence.
Email: khassan-2@yandex.ru
ORCID iD: 0000-0003-0191-1116
SPIN-code: 1247-1019

MD, PhD, Chief Researcher

Russian Federation, 1, st.Ostrovetianova, Moscow

Zaurbek Z. Magomedov

Kamchatka Regional Children’s Hospital

Email: dr.magomedov73@yandex.ru
ORCID iD: 0000-0001-6892-1023

chief of pediatric surgery

Russian Federation, 683024, Petropavlovsk-Kamchatsky, st. Ordgonikidze, 7

Dmitriy V. Kibalnic

Kamchatka Regional Children’s Hospital

Email: dr.dmitriy79@gmail.com
ORCID iD: 0000-0003-1980-3906

pediatric surgeon

Russian Federation, 683024, Petropavlovsk-Kamchatsky, st. Ordgonikidze, 7

Anastasia I. Lello

Kamchatka Regional Children’s Hospital

Email: alello@yandex.ru
ORCID iD: 0000-0001-9767-9088

pediatric surgeon

Russian Federation, 683024, Petropavlovsk-Kamchatsky, st. Ordgonikidze, 7

Andrey S. Akatiev

Kamchatka Regional Children’s Hospital

Email: andrei_akatev@mail.ru
ORCID iD: 0000-0002-0087-4256

pediatric surgeon

Russian Federation, 683024, Petropavlovsk-Kamchatsky, st. Ordgonikidze, 7

References

  1. Clarke NS, Murthy R, Hernandez J, et al. Aortoesophageal Fistula in a Child with Undiagnosed Vascular Ring: Life-Threatening or Lethal? Ann Thorac Surg. 2016;102(4):e325–327. doi: 10.1016/j.athoracsur.2016.03.054.
  2. Othersen HB Jr, Khalil B, Zellner J, et al. Aortoesophageal fistula and double aortic arch: two important points in management. J Pediatr Surg. 1996;31(4):594–595. doi: 10.1016/s0022-3468(96)90504-7.
  3. Mc Comas BC, van Miles P, Katz BE. Successful salvage of an 8-month-old child with an aortoesophageal fistula. J Pediatr Surg. 1991;26(12):1394–1395. doi: 10.1016/0022-3468(91)91043-x.
  4. Krieves MA, Merritt GR, Nichols CS, et al. Aortoesophageal fistula and coarctation of the aorta in a 15-year-old child. Semin Cardiothorac Vasc Anesth. 2013;17(4):294–297. doi: 10.1177/1089253213506789.
  5. Granata A, Gandolfo C, Acierno C, et al. Button battery removed from the stomach resulting in a missed aortoesophageal fistula — a multidisciplinary approach to rescuing a very young patient: a case report. J Med Case Rep. 2018;12(1):318. doi: 10.1186/s13256-018-1818-5
  6. Bartkevics M, Stankovic Z, Schibli S, et al. Miss and Salvage Management of Aortoesophageal Fistula Secondary to Cell Battery Ingestion. World J Pediatr Congenit Heart Surg. 2020;11(1):120–122. doi: 10.1177/2150135119880549
  7. Coates LJ, McNally J, Caputo M, Cusick E. Survival in a 2-year-old boy with hemorrhage secondary to an aortoesophageal fistula. J Pediatr Surg. 2011;46(12):2394–2396. doi: 10.1016/j.jpedsurg.2011.09.054
  8. Fuentes S, Cano I, López M, et al. Arterial-esophageal fistula: a severe complication in children with cardiovascular abnormalities. Pediatr Surg Int. 2010;26(3):335–337. doi: 10.1007/s00383-009-2532-6
  9. Hill SJ, Zarroug AE, Ricketts RR, Veeraswamy R. Bedside placement of an aortic occlusion balloon to control a ruptured aorto-esophageal fistula in a small child. Ann Vasc Surg. 2010;24(6):822.e7–9. doi: 10.1016/j.avsg.2009.12.016
  10. Woerkum F, van Bont L, Haas F, et al. Aortoesophageal fistula due to double aortic arch and prolonged nasogastric intubation: case report and review of the literature. Eur J Pediatr. 2006;165(9):660–661. doi: 10.1007/s00431-006-0137-9
  11. Snajdauf J, Mixa V, Rygl M, et al. Aortoesophageal fistula — an unusual complication of esophagitis caused by Dieffenbachia ingestion. J Pediatr Surg. 2005;40(6):e29–31. doi: 10.1016/j.jpedsurg.2005.03.036
  12. Panda SS, Agarwala S, Kabra SK, et al. Aortoesophageal fistula in a child. J Indian Assoc Pediatr Surg. 2013;18(3):124–126. doi: 10.4103/0971-9261.116051
  13. Takazawa S, Uchida H, Kawashima H, et al. Massive hemorrhage after Kasai portoenterostomy in a patient with a congenital extrahepatic portosystemic shunt, malrotation and a double aortic arch: report of a case. Surg Today. 2014;44(8):1561–1564. doi: 10.1007/s00595-013-0605-6
  14. Burns BJ, Newey A, Numa A. Beware the starboard nasogastric tube. Pediatr Emerg Care. 2008;24(5):307–309. doi: 10.1097/PEC.0b013e31816ecb17
  15. Razumovsky AYu, Romanov AV, Bataev SM. Coloesophagoplasty in a child with phlebectasia of the esophagus veins. Pediatric surgery. 1998;(3):6–10. (In Russ.)
  16. Miroshnikov BI, Gorbunov GN, Ivanov AP. Plastika pishhevoda. Saint Petersburg: JeLBI-SPb; 2012. P. 47–67. (In Russ.)
  17. Razumovskij AJu, Romanov AV, Bataev SM, et al. Sravnitel’naja ocenka rezul’tatov kolojezofagoplastiki u detej pri provedenii transplantata za grudinoj i v zadnem otdele sredostenija. Pediatric Surgery. 2000;(3):4–9. (In Russ.)
  18. Stepanov JeA, Razumovskij AJu, Bataev S.M., et al. Iskusstvennyj pishhevod u detej. Pirogov Russian Journal of Surgery. 2003;(7):6–16. (In Russ.)
  19. Alves N, Magalhães C, Almeida R, et al. Prospective study of Kawasaki disease complications: review of 115 cases. Rev Assoc Med Bras. 2011;57(3):295–300.
  20. Timen LJa, Shercinger AG, Zhigalova SB, et al. Anevrizma grudnogo otdela aorty s perforaciej pishhevoda. Experimental and Clinical Gastroenterology. 2010;(6):82–84. (In Russ.)
  21. Martin M, Steele S, Mullenix P, et al. Endoscopic Diagnosis of a Clinically Silent Aortoesophageal Fistula: Case Report and Review of the Literature. Washington Ann Vasc Surg. 2004;18(3):352–356. doi: 10.1007/s10016-004-0027-4
  22. Reardon М, Brewer R, Le Maire S, et al. Surgical Management of Primary Aortoesophageal Fistula Secondary to Thoracic Aneurysm. Ann Thorac Surg. 2000;69(3):967–970. doi: 10.1016/s0003-4975(99)01087-5.

Supplementary files

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1. JATS XML
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2. Fig. 1. Esophagoscopy. А tumor-like formation with an esophageal mucosal rupture

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3. Fig. 2. Autopsy. The arch and the descending part of the aorta were dissected. An aortic aneurysm penetrates the esophageal lumen. The probe is passed through the aortic aneurysm into the esophageal lumen

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