Upper gastrointestinal hemorrhage caused by a fistula from a right anomalous subclavian artery to the esophagus

• Published in: Revista da Associação Médica Brasileira (1992) Vol. 44; no. 2; pp. 149 - 151
• Main Authors: Colleoni Neto, R, Figueira, A, Belassai, E, Jorge Júnior, M E, Del Grande, J C, Cardoso, S H, Haddad, C M
• Format: Magazine Article
• Language: Portuguese
• Published: Brazil 01-04-1998
• Subjects: Adolescent; Esophageal Fistula - complications; Esophageal Fistula - surgery; Fatal Outcome; Gastrointestinal Hemorrhage - etiology; Humans; Male; Subclavian Artery - surgery; Vascular Fistula - complications; Vascular Fistula - surgery
• ISSN: 0104-4230

Bleeding from an arterio-esophageal fistula is a rare and nearly lethal condition and surgical treatment is the only curative option. We report a case of bleeding from a fistula from an aberrant right subclavian artery to the esophagus. Diagnosis was made only at necropsy, despite of three previous laparotomies. This anatomical variation is found in 0.5% of the general population. Development of a communication between this artery and the esophagus, secondary to aneurysmatic dilatation or to prolonged nasogastric intubation, as probably occurred with this patient, is a extremely rare condition. Surgical treatment depends on the early recognition of clinical signs of the arterio-esophageal communication, before the onset of systemic complications of hypovolemic shock.