# A novel approach to surviving an acute aorto-oesophageal fistula: A case report

## TL;DR

A life-threatening aorto-oesophageal fistula was managed using a Foley catheter to control bleeding before endovascular repair, showcasing an innovative emergency approach.

## Contribution

Demonstrates the novel use of a Foley catheter for emergency tamponade in aorto-oesophageal fistula cases.

## Key findings

- A 26Fr Foley catheter with 30ml saline in the balloon effectively controlled oesophageal bleeding.
- The tamponade provided temporary stability for subsequent endovascular stent placement.
- Innovative use of available tools can be lifesaving in critical surgical emergencies.

## Abstract

Acute aorto-oesophageal fistula poses a significant mortality risk, requiring immediate and decisive medical intervention. This report highlights the critical need for innovation in emergency surgical responses.

A 57-year-old male, with a history of aortic repair, presented with chronic anaemia and dysphagia. He suffered a cardiac arrest from massive hematemesis during surgery for an infected thoracic hematoma. Lacking a Stengsten-Blackmore tube, a 26Fr Foley catheter was used to control the bleeding. This measure stabilized the patient enough for a definitive endovascular repair with aortic stents, which successfully managed the bleeding.

The treatment objectives for this condition include initial control of oesophageal bleeding, followed by endovascular management to further control the bleeding, subsequently releasing the oesophageal control, and ultimately preventing infection through the administration of intravenous antibiotics.

This case illustrates the importance of adaptability and the use of unconventional methods in emergency situations, demonstrating that innovative solutions can be lifesaving in critical surgical emergencies.

•Aorto-oesophageal Fistula is immediately life-threatening.•A Foley Catheter (with 30ml of saline in balloon) can be used to tamponade bleeding in the oesophagus.•Tamponade transiently maintains stability until the patient can have definitive endovascular treatment.

Aorto-oesophageal Fistula is immediately life-threatening.

A Foley Catheter (with 30ml of saline in balloon) can be used to tamponade bleeding in the oesophagus.

Tamponade transiently maintains stability until the patient can have definitive endovascular treatment.