Aortoesophageal fistula, a life-threatening disease

Aortoesophageal fistula (AEF) is a rare complication associated with high morbidity and mortality. Primary fistulas are rare, usually occurring after endovascular stent graft reconstruction with secondary presentation. It is rarely recognised in time and therapy is often unsuccessful. We describe in detail the treatment of two patients diagnosed with AEF, with photo documentation. Unfortunately, both of our patients died. Based on a review of the literature and our own cases, we conclude that endovascular therapy in the acute haemorrhagic phase of AEF is a reasonable approach, but resection of the aorta and eroded oesophagus should be performed early to avoid serious complications. In patients who refuse surgery, vacuum therapy and the use of fibrin glue may be effective in milder cases.