Aberrant Right Subclavian Artery With Esophago-arterial Fistula
46 year-old female with massive upper GI bleed secondary to aberrant right subclavian artery-esophageal fistula formed during hospitalization following aorto-bi-iliac bypass. We suspect that pressure necrosis of the esophagus at the vulnerable position juxtaposed to the subclavian lead to this upper GI arterial bleed. After temporization of the bleed with Blakemore tube the patient went to the OR for stenting of the subclavian. Though the bleed was controlled, the patient's respiratory status continued to decline, and her family elected to withdraw care. We must emphasize the importance of perioperative surveillance of patients with aberrant aortic arch anatomy.
Constantinescu S, Soto RG, Al-Attar NC. Aberrant right subclavian artery with esophago-arterial fistula. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4802