Fatal Delayed Esophageal Rupture Following Aortic Clamping for Treatment of Stanford Type B Dissection

Hisao Ito, Takayuki Yamada, Tadashi Ishibashi, Masatoshi Akiyama, Takahiko Nakame, Yasuhiro Ito, Toshiaki Konnai

Research output: Contribution to journalArticlepeer-review

Abstract

A 65-year-old man underwent a thromboexclusion operation for management of chronic Stanford type B dissecting aneurysm in 1991. However, long-term follow-up CT scans after the operation revealed that the ascending aorta gradually enlarged and was eventually complicated by recurrent aortic dissection. The patient complained of frequent bloody sputum, whereas chest roentogenography showed no pulmonary abnormalities. Subsequent swallow esophagogram demonstrated that the upper esophagus was deviated to the right and the middle esophagus was greatly compressed by the aortic clamp. Esophageal endoscopy showed a bloody inner surface and marked swelling of the middle esophagus. The patient eventually died of massive hematemesis in 2001. We describe the imaging features of unanticipated complications such as recurrent dissecting aneurysm or impending esophageal rupture. Furthermore, we discuss the cause of hematemesis and document that the aortic clamp migrated and resulted in development of a recurrent aneurysmal dissection, which in turn resulted in esophageal rupture with aneurysmal disruption.

Original languageEnglish
Pages (from-to)557-560
Number of pages4
JournalCardioVascular and Interventional Radiology
Volume26
Issue number6
DOIs
Publication statusPublished - 2003

Keywords

  • Aortic clamping
  • CT
  • Esophageal rupture
  • Stanford type B dissecting aneurysm
  • Thromboexclusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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