CTICasesAortoesophageal Fistula secondary to Mycotic Aortic Aneurysm
Imaging findings
CT chest shows a large, destructive mycotic aneurysm of the distal aortic arch and descending aorta, associated with an esophageal perforation demonstrating oral contrast leakage directly abutting the aortic wall, representing an aortoesophageal fistula.
Key takeaways
Aortoesophageal fistula is a catastrophic, highly lethal condition. It can arise from primary esophageal pathology (foreign body, cancer) eroding into the aorta, or from a mycotic aortic aneurysm (commonly MRSA) eroding into the esophagus. Because of severe mediastinal contamination, surgical repair carries extremely high mortality.
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