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Infection in an Aortic-Esophageal Fistula

MARTIN LEFKOWITZ, MD; LOUIS J. ELSAS II, MD; ROBERT J. LEVINE, MD

Arch Intern Med. 1964;113(5):672-675.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Communication between the esophagus and the aorta occurs uncommonly. The usual cause is trauma ¹ incurred by the ingestion of a foreign body, or less often by surgery or penetrating chest wound. Another prominent cause of aortic-esophageal fistulae is carcinoma of the esophagus.² Aortic-esophageal fistulae are usually located at the level of the aortic arch ¹ where these two structures are approximated most closely.

The present communication presents what seems to be a unique situation. A patient who was trained in esophageal speech after total laryngectomy developed a hiatus hernia with peptic ulceration at the esophageal-gastric junction. This ulcer penetrated posteriorly into the aorta and produced fatal massive hematemesis through the resultant aortic-esophageal fistula. At postmortem examination yeast-like organisms, morphologically characteristic of Candida, were found in the wall of the aorta along the fistulous tract.

Report of a Case

A 62-year-old white man was admitted to the West Haven . . . [Full Text PDF of this Article]

Author Affiliations
WEST HAVEN, CONN.; NEW HAVEN, CONN.

From the departments of pathology and internal medicine, Veterans Administration Hospital, West Haven, Conn, and Yale University School of Medicine, New Haven, Conn.

Footnotes
Received for publication Sept 23, 1963; accepted Oct 21.

Resident in Pathology, VA Hospital, West Haven, Conn (Dr. Lefkowitz); Intern in Medicine, Yale University School of Medicine (Dr. Elsas); Chief Medical Resident, VA Hospital, West Haven, and Instructor in Medicine, Yale University School of Medicine (Dr. Levine).

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