Journal of Surgery

Case Report

Open Repair of Pediatric Aortoenteric Fistula from A Remote Gastric Transposition in Congenital Esophageal Atresia: A Multidisciplinary Approach

Snyder KB1,2*, Farnell C3, Buonpane C1,2, Gierman JL2,3, Hunter CJ1,2 and Landmann A1,2

1Division of Pediatric Surgery, Oklahoma Children’s Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City, USA.
2The University of Oklahoma Health Sciences Center, Department of Surgery, 800 Research Parkway, Suite 449, Oklahoma City, OK USA.
3The University of Oklahoma Health Sciences Center, Department of Vascular Surgery, 800 Research Parkway, Suite 449, Oklahoma City, OK USA
*Address for Correspondence: Katherine B. Snyder, Department of Pediatric Surgery Oklahoma Children’s Hospital, Oklahoma City, USA. Email Id: Katherine-snyder@ouhsc.edu
Submission:11 January 2024 Accepted:07 February 2024 Published:12 February, 2024
Copyright: © 2024 Snyder KB, et al. Powell BS, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 12-year-old male with history of long gap esophageal atresia with a gastric transposition at one year of age presented with multiple episodes of hematemesis. He recently had been prescribed high dose NSAIDs for pericarditis. He underwent multiple endoscopic cauterizations of a large gastric ulcer and despite this required MTP. CTA was obtained showing hypoattenuation of the gastric conduit along the aorta near the area that was cauterized. The patient underwent a left-thoracotomy and gastrotomy. Once hematoma was evacuated, a large pulsatile bleed was encountered. Pressure was held and control of the aorta was obtained. The gastric conduit was dissected off the aorta, revealing a large defect. The gastric conduit was repaired, the aorta was repaired with bovine pericardium and pleural flap was placed. On POD 8 a swallow study demonstrated no leak and the patient was discharged on POD 15. Outpatient follow-up CTA demonstrated an intact repair.