IMAGES IN IR
Traumatic Carotid Esophageal Fistula Atabak Allaei, MD, and Patrick Hammill, MD An 18-year-old African-American man was brought in by emergency services status post gunshot wound to the thorax. Computed tomography angiography of the chest revealed a right hemopneumothorax (h) and pooling of intravenous contrast material within the esophagus (e) (Fig 1). A fistulous communication was demonstrated (arrows) between the left common carotid artery (a) and the esophagus (e) (Fig 2). A massively distended stomach containing blood clots (s) was identified
along with signs of hypovolemic shock including a small-caliber aorta (a) and a dense pancreas (p) (Fig 3). With identification of the carotid esophageal fistula, the trauma team was guided to attend to the major injury, and the patient was taken to the operating room. The patient subsequently died approximately 90 minutes later as a result of marked exsanguination and gravity of occult injuries, as confirmed on autopsy, which also included pulmonary and caval injuries.
Figure 1 Figure 2
Figure 3
From the Department of Radiology, State University of New York, Downstate Medical Center, 451 Clarkson Avenue, Box #47, B Building, 3rd Floor, Room B3304, Brooklyn, NY 11203. Address correspondence to A.A.; E-mail: [email protected]
& SIR, 2015
Neither of the authors has identified a conflict of interest.
http://dx.doi.org/10.1016/j.jvir.2015.01.026
J Vasc Interv Radiol 2015; 26:1566
Traumatic Carotid Esophageal Fistula Atabak Allaei, MD, and Patrick Hammill, MD An 18-year-old African-American man was brought in by emergency services status post gunshot wound to the thorax. Computed tomography angiography of the chest revealed a right hemopneumothorax (h) and pooling of intravenous contrast material within the esophagus (e) (Fig 1). A fistulous communication was demonstrated (arrows) between the left common carotid artery (a) and the esophagus (e) (Fig 2). A massively distended stomach containing blood clots (s) was identified
along with signs of hypovolemic shock including a small-caliber aorta (a) and a dense pancreas (p) (Fig 3). With identification of the carotid esophageal fistula, the trauma team was guided to attend to the major injury, and the patient was taken to the operating room. The patient subsequently died approximately 90 minutes later as a result of marked exsanguination and gravity of occult injuries, as confirmed on autopsy, which also included pulmonary and caval injuries.
Figure 1 Figure 2
Figure 3
From the Department of Radiology, State University of New York, Downstate Medical Center, 451 Clarkson Avenue, Box #47, B Building, 3rd Floor, Room B3304, Brooklyn, NY 11203. Address correspondence to A.A.; E-mail: [email protected]
& SIR, 2015
Neither of the authors has identified a conflict of interest.
http://dx.doi.org/10.1016/j.jvir.2015.01.026
J Vasc Interv Radiol 2015; 26:1566
