感染性胸部大動脈瘤破裂・食道穿破の1例

Aortoesophageal Fistula with Infected Thoracic Aortic Aneurysm Rupture；Report of a Case

感染性胸部大動脈瘤破裂による食道穿破や大動脈食道瘻はまれであるが，発症した場合の救命率はきわめて低いとされている1）．われわれは感染性胸部大動脈瘤破裂・食道穿破に対して胸部ステントグラフト内挿術（thoracic endovascular aortic repair：TEVAR）後に食道二期再建し救命を得た1例を経験したので，文献的考察を加えて報告する．

A 67-year-old man was referred to our hospital because of fever and discomfort of the throat. Gastrointestinal endoscopy revealed hematoma at the middle thoracic esophagus. Computed tomography revealed posterior mediastinal hematoma extending the descending aorta. Bacillus was detected in the blood culture. Aortoesophageal fistula with an infected thoracic aortic aneurysm rupture was diagnosed. First, thoracic endovascular aortic repair （TEVAR） was performed. Resection of the thoracic esophagus and omentopexy was conducted 15 days after TEVAR. Esophageal reconstruction using a gastric tube was performed 43 days after esophagectomy. He has been doing well since then.