Staged repair using omentum for posttraumatic aortoesophageal fistula

Aortoesophageal fistulas from traumatic thoracic aortic pseudoaneurysms are almost uniformly fatal. We report a case of a young woman who nearly exsanguinated soon after diagnosis. Immediate operative intervention consisted of prosthetic graft replacement of the pseudoaneurysm and pleural patch coverage. Definitive treatment of the esophageal perforation was necessary later for mediastinal sepsis. Primary repair of the esophagus accompanied by mobilization of the omentum into the space between the esophageal closure and the prosthetic graft led to a successful outcome.