CTICasesAorto-Esophageal Fistula Secondary to Infected Aortic Graft
Imaging findings
CT reveals gas, soft tissue, and fluid in the mediastinum surrounding an aortic graft that was placed 1.5 years prior for dissection repair. Abnormal contours and loose contrast spilling into the mediastinum are noted. The esophagus is distended with dense fluid (30 Hounsfield units), and high attenuation material is present in the stomach, confirming an aorto-esophageal fistula related to an infected graft. Atelectatic lung is also present.
Key takeaways
Aorto-esophageal fistula is a rare but catastrophic complication of aortic dissection repair, particularly with infected grafts. Imaging findings include mediastinal gas, fluid, abnormal graft contours, and contrast extravasation into the esophagus. This condition has a very poor prognosis and often presents with GI bleeding.
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