Surgical Treatment of a Patient with Aorto-pulmonary Fistula due to Thoracic Aortic Aneurysm Rupture Associated with Gastric Carcinoma

(Second Department of Surgery, Yamanashi Medical University, Yamanashi, Japan)

Shinya Motohashi Shunya Shindo Kenji Kubota
Atsuo Kojima Tadao Ishimoto Keiji Iyori
Masahiro Kobayashi Yusuke Tada
A 57-year-old man suffered hemoptysis during an examination for gastric carcinoma. Enhanced computed tomography demonstrated rupture of a thoracic aortic aneurysm to the left pulmonary lower lobe. The lateral segment of the liver was atrophic due to intrahepatic cholelithiasis. Emergency operation was performed after he was transferred to our hospital. The thoracic aorta was reconstructed using a temporary bypass and the pulmonary left lower lobe was resected. The omentum was mobilized and used to cover the prosthesis and bronchial stump. The gastric carcinoma and intrahepatic cholelithiasis with biliary stones in the common bile duct were treated in the next procedure. The pathologic examination revealed lymph node metastasis; thus this operation was recognized to be absolutely noncurative. The treatment of cardiovascular disease concomitant with malignancy remains controversial. The strategy to treat such patients is discussed in this report.
@Jpn. J. Cardiovasc. Surg. 30: 265-267 (2001)