[A Case of Aortoesophageal Fistula Rupture Due to Descending Thoracic Aortic Dissection with Recurrent Colon Cancer during Chemotherapy Containing Bevacizumab].

Abstract

We report a case of aortoesophageal fistula rupture during the course of chemotherapy following colon cancer resection. The patient was a 77-year-old woman. Following recurrence of cancer of the sigmoid colon, the patient received a course of XELOX plus bevacizumab(Bmab)to treat peritoneal dissemination and lung metastases. She was brought by ambulance to our hospital's emergency department 55 days after the last dose of Bmab, with a chief complaint of hematemesis. Hematolo- gy results showed severe anemia with a hemoglobin level of 4.0 g/dL. Descending thoracic aortic dissection was noted on chest CT with contrast, and the patient was diagnosed with an aortoesophageal fistula rupture. She underwent emergent endovascular chest stent grafting to control the bleeding. Although the ruptured esophagus was a potential source of infection, the patient and family members chose palliative treatment. Therefore, conservative treatment was administered without removing the esophagus. The patient's postoperative course was good; instead of resuming oral intake, the patient was discharged on home IVH 59 days after surgery. Outpatient follow-up continued, but multiple metastases led to gradual worsening of the patient's general condition. She died 168 days after being admitted for surgery.

• Authors: Takamaru Koda, Junichi Koike, Hiroshi Masuhara, Akiharu Kurihara, Hiroyuki Shiokawa, Mitsunori Ushigome, Tomoaki Kaneko, Takayuki Suzuki, Yuko Sawaguchi, Tomoyuki Katayanagi, Takerou Fujii, Yoshinori Watanabe, Kimihiko Funahashi, Hideaki Shimada, Hironori Kaneko
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 43 Issue 12 Pg. 1815-1817 (Nov 2016) ISSN: 0385-0684 [Print] Japan
• PMID: 28133141 (Publication Type: Case Reports, Journal Article)

Chemical References

• Oxaloacetates
• Deoxycytidine
• Bevacizumab
• Capecitabine
• Fluorouracil

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Aortic Diseases (etiology, surgery)
• Bevacizumab (administration & dosage, adverse effects)
• Capecitabine
• Colonic Neoplasms (drug therapy)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Esophageal Fistula (etiology, surgery)
• Fatal Outcome
• Female
• Fluorouracil (administration & dosage, analogs & derivatives)
• Humans
• Oxaloacetates
• Postoperative Complications
• Recurrence