Diffuse intrinsic pontine glioma with aberrant right subclavian artery–esophageal fistula induced by nasogastric tube

DOI
  • Nakagawa Shunsuke
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
  • Okamoto Yasuhiro
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
  • Hazeki Daisuke
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
  • Kodama Yuichi
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
  • Nishikawa Takuro
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
  • Eguchi Taisuke
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
  • Hayashi Sadao
    Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences
  • Kawano Yoshifumi
    Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences

Bibliographic Information

Other Title
  • 経鼻胃管によって異所性右鎖骨下動脈–食道瘻を来したびまん性橋膠腫

Search this article

Abstract

<p>An aberrant right subclavian artery (ARSA)–esophageal fistula is rare but highly fatal. A 4-year-old female patient with diffuse intrinsic pontine glioma presented with sudden massive hematemesis. Upper gastrointestinal endoscopy revealed massive pulsing bleeding from an ulcer in contact with a nasogastric tube (NGT) in the upper esophagus. A balloon in the esophagus stopped the bleeding temporally, and computed tomography revealed an ARSA–esophageal fistula. Transarterial embolization (TAE) stopped the bleeding completely, and she was saved. This is the first case of a pediatric cancer patient of its kind. Mucosal damage induced by chemotherapy might contribute to fistular development. Furthermore, this is the first report of a successful rescue of a patient with an ARSA–esophageal fistula by TAE. Therefore, we suggest evaluating the existence of ARSA in pediatric cancer patients with NGT insertion and treated with chemotherapy. TAE is effective in stopping the bleeding from an ARSA–esophageal fistula.</p>

Journal

Details 詳細情報について

Report a problem

Back to top