Successful Surgical Treatment for an Aortoesophageal

The patient was a 68-year-old man who consulted another hospital with a chief complaint of dysphagia, and was referred to our hospital based on a suspicion of esophageal submucosal tumor. However, the patient was emergently admitted due to hematemesis and hypotension, which occurred immediately after the acquisition of computed tomographic (CT) images for further examinations at the outpatient clinic. Contrast-enhanced chest CT demonstrated a thoracic aortic aneurysm measuring 45 mm in maximal diameter, in addition to pneumati-zation adhering to mural thrombus, which appeared to be the esophagus. Upper gastrointes-tinal endoscopy also demonstrated ulcerative lesions accompanied by coagulations in the middle thoracic esophagus. Therefore, emergency surgery was performed based on a diag-nosis of an aortoesophageal fistula due to a descending aortic aneurysm. Graft replacement was performed under partial extracorporeal circulation, followed by total thoracic esophagectomy, esophagostomy, and gastrostomy after weaning from extracorporeal circu-lation. This study reports the course of a patient with an aortoesophageal fistula due to a thoracic aortic aneurysm whose life was successfully saved by emergency surgery, togethe