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Case study reports severe aortoesophageal fistula following endovascular repair of a mycotic thoracic aneurysm after botulinum toxin injections, highlighting the need for radical surgical therapy.
Endoscopic botulinum toxin injections to the esophagus is a safe and effective treatment for the management of achalasia or distal esophageal spasms. This case study describes a complication of late mycotic aneurysm formation at the level of the descending thoracic aorta requiring urgent endovascular repair. Afterwards, development of an aortoesophageal fistula demanded radical surgical therapy consisting of esophageal resection, stent-graft removal and both aortic and esophageal reconstruction.
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Huysmans et al. (2022) studied this question.
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