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. 

Complications
CT

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%).

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Article Information

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

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