Aorto-esophageal fistula

Case contributed by Ian Bickle
Diagnosis certain


Female pensioner with known esophageal cancer. Esophageal stent 1 month prior. Haematemasis. Cause?

Patient Data

Age: 74
Gender: Female

Oseophageal stent in situ.

Soft tissue occupying most of the esophageal lumen at the level of the carina.

Contrast extending from the descending aorta into the lumen of the esophagus at the level of the pulmonary trunk.

Soft tissue in the para-esophageal space in keeping with tumor extension.

Case Discussion

Very exciting case - one of my best in the last 5 years.

Known to happen, but rare to experience.  Thankfully.

On the arterial phase CT study the contrast extends across the aorta and through the stented esophagus at the site of the upper esophageal tumor.

An aorto-esophageal fistula.

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