Atrio-oesophageal fistula

Atrial-oesophageal fistulas are rare pathological connections between the left atrium and the oesophagus

The presentation is non-specific. Patients may complain of fever, malaise, dysphagia or present with neurological symptoms 3

The chief cause of atrial-oesophageal fistulas is iatrogenic in the setting of cardiac ablation procedures. Although theoretically many mediastinal pathologies or procedures could also cause a fistula. 

CT is the modality of choice, and may reveal a communication between the left atrium and the oesophagus which can be evidenced by IV contrast present in the oesophagus.

Other possible features include:

The treatment is surgical including resection and repair of the necrotic heart tissue and oesophageal resection of fistulous area. Oesophageal stenting can be used as a temporizing measure. Mortality rate is high at ~60% (range 40-80%).

Share article

Article information

rID: 41801
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Atrio-esophageal fistula
  • Atrioesophageal fistula
  • Atriooesophageal fistula
  • Atrio-oesophageal fistulation

Support Radiopaedia and see fewer ads

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.