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  • Title: Oesophageal bleeding from aortoesophageal fistula due to aortic aneurysm.
    Author: Myers HS, Silber W.
    Journal: S Afr Med J; 1983 Jan 22; 63(4):124-7. PubMed ID: 6600293.
    Abstract:
    From pathology data it appears that aortic aneurysm may be the commonest cause of aorto-oesophageal fistula (AOF), but this entity is rarely diagnosed clinically. We report 6 patients, seen during a 5-year period, with aneurysms which initially caused chest pain and minor oesophageal bleeding. The diagnosis of AOF was made before death in only 1 case; surgery was not attempted. This patient and 4 others died when rupture into the oesophageal lumen or wall caused exsanguinating haemorrhage. The 6th patient, who died after prostatectomy without a major haemorrhage, had oesophageal fibrosis localized at the aneurysm; this type of lesion occurs in the development of a fistula. The therapeutic ideal is to forestall fatal rupture by prompt diagnosis and immediate surgery when mild oesophageal bleeding gives warning of fistula formation.
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