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Gastropleural Fistula with Aortic Intramural Involvement
Akshya Gupta1, Abhishek Chaturvedi1, Patrick Fultz1
1Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA.
Journal of Clinical Imaging Science
|March 17, 2017
Summary
Gastropleural fistula, a rare complication, can erode into the aorta. Prompt diagnosis using computed tomography (CT) is crucial for effective management of this uncommon condition.
Area of Science:
- Gastroenterology and Thoracic Surgery
- Diagnostic Imaging
Background:
- Gastropleural fistula is a rare complication arising from various causes, including trauma, surgery, and neoplastic conditions.
- It most frequently occurs in patients with diaphragmatic hernias or a history of thoracic surgery.
- Aortoenteric fistulas are uncommon communications between the aorta and the gastrointestinal tract.
Observation:
- This report details a rare case of an 88-year-old male who developed a gastropleural fistula.
- The fistula exhibited erosions into the descending thoracic aorta.
- Computed tomography (CT) is highlighted as a primary diagnostic tool due to its speed and accessibility.
Findings:
- The case illustrates a complex gastropleural fistula with aortic involvement, a highly unusual presentation.
- CT imaging is essential for identifying the fistula and its extent, particularly when involving major vascular structures.
- Understanding the characteristic CT appearance is vital for timely diagnosis.
Implications:
- This case underscores the importance of considering rare complications like aortoenteric fistulas in patients with gastropleural fistulas.
- Effective utilization of computed tomography (CT) protocols is critical for prompt and accurate diagnosis.
- Early diagnosis through advanced imaging can significantly impact patient outcomes and treatment strategies.
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