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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 3, May/June 2016
AFRICA
e17
time, but iatrogenic aorto-oesophagial rupture occurs suddenly
and progresses quickly to haemorrhagic shock.
7,9
Therefore 80
to 90% of aortic injuries are fatal, and immediate aortic repair
is important for survival.
7
In our case, immediate aortic surgery
was carried out after controlling the bleeding with a polyethylene
balloon and CT detection of the injury.
Contrast CT scan is a suggested imaging technique
for detecting the site of aortic injury and its relationship
with surrounding structures.
3
However, angiography can be
undertaken for determining aortic pathology and treatment
of the injury with endovascular techniques.
3,8
Repair with an
endovascular graft is a safer option for acute aortic injury.
However, there is limited experience with this procedure in the
paediatric population and natural progression of the stent is
not fully known. Therefore, open surgical repair is the preferred
technique for paediatric patients with aortic injury.
8,10
In accordance with the therapeutic opportunities of the
surgical centre, an appropriate method should be chosen and an
immediate treatment protocol should be determined. In our case,
we decided on open repair with simultaneous intervention on the
aortic injury and oesophageal rupture.
Conclusion
Aortic wall injury may occur during oesophagoscopy. Balloon
dilatators may be helpful to control bleeding and secure time for
surgical repair. Open aortic repair may ensure patient survival
and it allows simultaneous oesophageal repair.
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