Aortoesophageal fistulae following TEVAR: Case report and literature review

Q4Q3Pacientes con Fístula aortoesofágicaIntroduction: Aortoesophageal fistulae are an uncommon pathology, primarily due to the aortic pathology in more than 50 % of the cases, followed by foreign body ingestion, and advanced malignancies. Recently it is recognized after surgical management of thoracic aortic pathologies either open or endovascular, with increased rates of morbidity and mortality. Presentation of the case: We present a 62-year-old male patient with a previous history of thoracic endovascular aortic repair, who enters the emergency room with gastrointestinal bleeding and clinical signs of infection. Positive blood cultures, and tomographic signs include prosthetic gas, with endoscopic findings of aortoesophageal fistulae. Aggressive surgical management was performed including esophageal resection and gastrointestinal exclusion. Bleeding control was reached in the early postoperative period, nevertheless despite multidisciplinary management, the patient died 8 days after surgery. Clinical discussion: Aortoesophageal fistulae, remains to be an uncommon complication either of thoracic aortic aneurysm or after endovascular treatment of aortic aneurysm; with high rates of morbidity and mortality, should be suspected in every case with upper gastrointestinal bleeding in the context of a patient with aortic disease. Non-surgical management should be avoided due to the high risk of complications and mortality, aggressive management needs to be considered in each case according to clinical condition of the patient. Conclusion: Aortoesophageal fistulae remain an uncommon complication after TEVAR, with increased mortality and morbidity rates after complete treatment. Conservative management should be avoided to achieve bleeding control and prevent the extension of the infection.https://orcid.org/0000-0001-6888-5595https://orcid.org/0000-0002-8977-0647https://orcid.org/0000-0002-3503-8493https://orcid.org/0000-0001-5550-9144Revista Internacional - IndexadaBN

Central airway disease Post-intubation tracheal stenosis

Desde la aparición de la enfermedad por SARS-CoV-2, han cambiado paradigmas en la ciencia médica y actualmente nos enfrentamos a las repercusiones a largo plazo que algunos de los pacientes desarrollan. Entre el grupo de pacientes que han cursado con neumonía severa-síndrome de dificultad respiratoria aguda (SDRA) por SARS-CoV-2 y que requirieron intubación orotraqueal (IOT), se documentan complicaciones multisistémicas (1-4). En este artículo destacaremos las complicaciones relacionadas con la vía aérea que se presentan en forma de estenosis benignas, siendo las lesiones subglóticas tipo simples o complejas las más frecuentes. A continuación, presentamos el caso de un paciente que presentó estenosis traqueales pos-IOT a causa de una neumonía severa por COVID-19 con diagnóstico, seguimiento y manejo por un grupo multidisciplinario de vía aérea.Pacientes con COVID-19Since the appearance of SARSCoV-2 disease, paradigms have changed in medical science, and we are currently facing the long-term repercussions that some of the patients develop. Within the group of patients who have had severe pneumonia - Acute respiratory distress syndrome (ARDS) due to SARSCoV-2 and who required orotracheal intubation (OTI), multisystemic complications are documented (1-4), in In this article, we will highlight airway-related complications that occur in the form of benign stenosis, with simple or complex subglottic lesions being the most common. We present a case of a patient who presented tracheal stenosis post-OTI due to severe COVID-19 pneumonia as main diagnosis, follow-up, and management by a multidisciplinary airway group.https://orcid.org/0000-0002-1783-7769https://orcid.org/0000-0003-3975-2835https://orcid.org/0000-0002-3743-6268https://orcid.org/0000-0002-3061-5212https://orcid.org/0000-0002-3721-3312https://orcid.org/0000-0002-6925-3570https://orcid.org/0000-0001-6461-2725Revista Nacional - IndexadaN