Aortoesophageal fistula with hemorrhagic shock successfully treated with resuscitative endovascular balloon occlusion of the aorta

Abstract Background Aortoesophageal fistula (AEF) is a rare cause of upper gastrointestinal hemorrhage. Despite diagnostic and therapeutic advances, the mortality rate in AEF patients remains high because of its fulminant course, even with maximal intensive care. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a resuscitation technique to control life-threatening bleeding. It has become an important modality in the management of life-threatening, traumatic or non-traumatic, arterial bleeding. However, its use in hemorrhagic shock caused by cancer has rarely been reported. Case presentation : A 51-year-old female with a history of esophageal cancer presented to our emergency department with hematemesis. Computed tomography was performed because of a strong suspicion of hemorrhagic shock. With a diagnosis of AEF due to esophageal cancer, emergency thoracic endovascular aortic repair was performed while the bleeding was controlled using REBOA. Staged elective esophageal reconstruction was successfully performed. Conclusions Hemostasis is of paramount importance in individuals presenting with suspected hemorrhagic shock attributable to arterioenteric fistula (AEF). The timely implementation of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has shown promise in these circumstances, showcasing potential effectiveness.