Mycotic Aneurysm Of Thoracic Aorta Research Articles

Mycotic aneurysm of the distal thoracic aorta after botulinum toxin injection for esophageal dysmotility

Endoscopic injection of botulinum toxin is a common method to treat esophageal dysmotility and achalasia. Patients undergoing this procedure who subsequently present with abdominal or back pain and constitutional symptoms should be evaluated for possible complications of the procedure, including occult esophageal perforation, mediastinitis, and mycotic aneurysm of the thoracic aorta. The case described herein illustrates the importance of serial imaging in a patient with persistent symptoms after botulinum toxin injection to identify and to treat occult aortic inoculation leading to mycotic aneurysm before sepsis and aortic rupture ensue with their attendant morbidity and mortality risks.

Aortoesophageal Fistula with a History of Graft Treatment for Thoracic Aortic Aneurysm

Aortoesophageal fistula (AEF) is a rare but fatal cause of gastrointestinal hemorrhage, being most commonly associated with thoracic aortic aneurysm. We present a rare case of secondary AEF post graft treatment for mycotic aneurysm of thoracic aorta 4 years previously. Massive upper gastrointestinal hemorrhage resulted in difficult diagnosis by gastrointestinal endoscopy. Computed tomography angiography (CTA) showed contrast extravasation from the descending aorta into the mid-third esophagus. CTA is a useful diagnostic tool in patients suspected of having AEF. Rapid identification of AEF is important for definitive treatment and increases the likelihood of survival.