The authors report the clinic case of a 54 years old male, whose chief complaints were
dysphagia for solid foods, epigastralgias and remarkable
weight loss, of 20 kilos in two months. Admitted in another hospital with the diagnosis of esophagus
tumor, an upper G.I. endoscopy disclosed an extensive external compresion of the esophagus middle third and the CT-chest scans revealed a large
descending thoracic aortic aneurysm, in chronic contained
rupture, as the cause of the compression. The patient was immediately transferred to our hospital and underwent the conventional surgical management, consisting in the
aneurysm resection and replacement with a 30 mm
Dacron prosthesis. The post-operative course was uneventful and reviewed four months following the operation he was found in good
condition, asymptomatic and displaying a remarkable
weight gain. In era of a progressive expansion of the field of the endovascular management of
thoracic aortic aneurysms, some cases, like the present clinical case, seem to represent a formal
contraindication to the endovascular technology, due to the irreducible external compression of organs such as the esophagus, thus remaining an exclusive indication for the conventional surgical management.