An unusual case of dysphagia after endovascular exclusion of thoracoabdominal aortic aneurysm.
Relato de caso conduzido no Instituto Científico San Raffaele, em Milão. Uma mulher de 79 anos foi submetida a reparo híbrido estagiado de aneurisma da aorta toracoabdominal e desenvolveu disfagia e regurgitação logo após o implante da endoprótese na aorta torácica.
A investigação por imagem do esôfago mostrou estenose endoluminal acentuada, sugerindo o desenvolvimento de acalasia secundária. A paciente foi tratada com injeções endoscópicas de toxina botulínica no esfíncter esofágico inferior, com resolução completa dos sintomas.
A síndrome disfágica aguda após endoprótese de aorta torácica tem apenas relatos anedóticos na literatura, e sua etiologia permanece indefinida.
Abstract
Purpose. To report an unusual case of dysphagia that developed immediately after stent-grafting of a thoracoabdominal aortic aneurysm.
Case report. A 79-year-old woman was submitted to a staged hybrid repair of a thoracoabdominal aortic aneurysm and developed new onset dysphagia and regurgitation early after stent-grafting of the thoracic aorta. Esophageal imaging showed a marked endoluminal stenosis, suggesting the development of secondary achalasia. The patient was submitted to endoscopic injections of botulinum toxin at the lower esophageal sphincter, which completely resolved the symptoms.
Conclusion. Acute dysphagic syndrome after thoracic aorta endografting has been anecdotically reported, and its etiology remains undefined. In this report, we illustrate the clinical features of this rare condition, discuss etiological hypotheses, and suggest a noninvasive therapeutic approach.
Original abstract as published in Journal of Endovascular Therapy.