CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S32
DOI: 10.1055/s-0041-1730736
Abstract

Penetrating Aortic Ulcer Presenting as Hematemesis

U Gurunandan
Sir Ganga Ram Hospital, New Delhi, India
,
Ambarish Satwik
Sir Ganga Ram Hospital, New Delhi, India
,
V S Bedi
Sir Ganga Ram Hospital, New Delhi, India
,
Sandeep Agarwal
Sir Ganga Ram Hospital, New Delhi, India
,
Ajay Yaday
Sir Ganga Ram Hospital, New Delhi, India
,
Apurva Srivastava
Sir Ganga Ram Hospital, New Delhi, India
› Author Affiliations

Background: Aortoesophageal fistula (AEF) is a rare and life-threatening condition with fatal outcome if not identified and treated early. In more than half of the cases, aortic aneurysm rupture is the causative factor. There are only a few case reports of aortic ulcer presenting as hematemesis or hemoptysis in the literature. We are presenting a case of penetrating aortic ulcer with hematemesis. Methods: A 61-year-old male, smoker, hypertensive presented to the emergency with a history of syncope and hematemesis 4 days back. Physical examination showed blood pressure of 100/90 mmHg, heart rate of 110 bpm, and normal pulse in both legs. Patient was admitted in Intensive Care Unit and emergency computed tomography scan revealed descending thoracic aortic ulceration. Results: The patient underwent successful endovascular repair and was discharged after 8 days in a stable condition. Conclusion: AEF is a rare and dreaded cause of upper gastrointestinal hemorrhage. Many patients present with herald bleeding before the final exsanguination, which is critical to recognize as it allows window period for diagnostic and therapeutic maneuvers. In the present endovascular era, penetrating aortic ulcers can be safely treated with minimal procedure-related morbidity and mortality.



Publication History

Article published online:
11 May 2021

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