An aortic oesophageal fistula (AEF) should be considered in any patient with severe bleeding following oesophagoscopy. A history of haematemesis in a dog with an oesophageal foreign body should raise suspicion of the presence of an AEF and dictate case management accordingly
Journal citation

Rimer. D., Lerman. O., Klainbart, S., et al (2020)
Lethal acute hemorrhage from an aortoesophageal fistula following endoscopy-assisted esophageal foreign body removal in a dog
Journal of Veterinary Emergency and Critical Care; 30 (5) 587-591
Abstract

Published September/October 2020

Type of study
  • Case report
  • n = 1 dog
Key points
  • Catastrophic haemorrhage following oesophageal foreign body removal is a rare complication in dogs
  • An aortic oesophageal fistula is defined as an abnormal direct communication between the aorta and the oesophagus
  • This is the first report of an acute fatal haemorrhage from an aortic oesophageal fistula immediately following successful endoscopy guided oesophageal foreign body removal
  • In humans it has been shown that a high percentage of fatal cases present with a history of mild “sentinel” bleeds
  • This case also presented with a 6 day history of haematemesis which is not commonly described in dogs with oesophageal foreign bodies
  • It is therefore suggested that a history of sentinel bleeding in a dog with an oesophageal foreign body (haematochezia or melena) should raise the clinical suspicion of an aortic oesophageal fistula
  • However, even if diagnosed premortem, this condition carries a poor prognosis in dogs

Limitations

Single case report

Conclusions
  • A history of haematemesis in a dog with an oesophageal foreign body should raise the suspicion of the presence of an aortic oesophageal fistula and dictate case management accordingly