A rare cause of haematemesis with fatal gastrointestinal bleeding

作者：Vogel Y^*; Keilmann O; Jochheim R; Tannapfel A

来源：Internist, 2010, 51(8): 1053-1056.

DOI：10.1007/s00108-009-2551-3

• Septicemia
• Arteriosclerosis
• Hematemesis
• Aortoesophageal fistula
• Mycotic aneurysm

A 73-year-old man was admitted to the hospital due to severe hematemesis and collapse, severe anemia and inflammation. Two months ago, the patient had been treated with antibiotics due to septicemia with staphylococcus aureus. At that time CT scan had shown only thoracic arteriosclerosis. The subsequent high urgency upper endoscopy identified a circular mucosal defect in distal esophagus as bleeding origin. The patient died 10 hours after admission. Performing autopsy, a fistula between the thoracic aortic aneurysm and the distal esophagus was found in the background of severe arteriosclerosis. The rapid onset of an aneurysm with rupture after a bacterial infection is typical for a mycotic aneurysm.

• 出版日期2010-8