Abstract
Although infected aortic aneurysm and aorto-esophageal fistula are considered conditions with high fatality rates, we report a case successfully treated with two-stage esophageal resection and digestive tract reconstruction after thoracic endovascular aneurysm repair (TEVAR) without aortic wall resection. The patient was a 74-year-old man who presented with swallowing difficulty, fever, and cervical subcutaneous hematoma, and was diagnosed with descending thoracic aortic aneurysm rupture. Gore TAG stent graft was deployed first. Campylobacter fetus was detected in the blood culture. The definitive diagnoses were infectious aortic aneurysm rupture and aorto-esophageal fistula. The postoperative infection was well controlled with antibiotic therapy. Esophageal resection and reconstruction, as well as omental implantation, were conducted on day 36 after TEVAR. Intravenous antibiotic therapy was continued for 1 month, and the patient was discharged on admission day 67 without any increase in inflammatory response. No exacerbation of infection was observed even after 1 year after TEVAR, and the patient showed satisfactory progress.
