A 70-year-old man reported dysphagia two months after undergoing thoracic endovascular aortic repair (TEVAR). An endoscopic examination revealed a fistula between the esophagus and the thoracic aortic aneurysm, and computed tomography (CT) showed that the thoracic aortic aneurysm had increased in size. The patient was diagnosed with an aortoesophageal fistula (AEF), and surgical replacement of the thoracic aorta was performed. AEFs are a rare but typically fatal complication after TEVAR. Physicians should consider a diagnosis of AEF and perform endoscopic examinations and CT in patients who undergo TEVAR and subsequently complain of dysphagia.
2013 by The Japanese Society of Internal Medicine