[Severe XXXX of a rare cause: @entity1727 successfully treated].

@entity1 @entity8721 @entity2009 @entity548 @entity6552 @entity167 @entity34 @entity1066 @entity1727 @entity1395 @entity158 @entity1344 @entity360 @entity2459
@entity1727 is a rare entity, determining huge digestive @entity548 with a very poor prognostic most often. We present the case of a @entity1 with @entity1727 of unknown origin, treated successfully in the Center of Surgery and Liver Transplantation from Fundeni Clinical Institute. A young @entity1 , 21 years old, was admitted in our clinic from another hospital for repetitive severe @entity360 , with @entity6552 and melena, pale, @entity1395 , without any @entity158 ; the @entity548 stopped when he was admitted. The upper digestive endoscopy and esophago-gastro-duodenal radioscopy with barium did not show any lesion. During the 7th day the @entity1 presents @entity2459 with @entity1344 ; during the surgery we found two subcardial @entity1066 (stress @entity1066 ?) for which we have done excision and suture which temporary stopped the @entity548 . After 14 days, the @entity1 had another massive @entity548 ; the upper endoscopy shows 28 cm far from the dental arch a protrusive formation of 6-7 mm with a @entity8721 aspect and with a white spot (possibly a central ulceration); 1 ml pure @entity167 was injected inside it with temporary @entity548 ceasing. After 3 days the @entity1 is @entity548 again, with marked decrease in blood pressure; a Blakemore tube stopped the @entity548 until surgery was performed. During the intervention an @entity2009 is detected; we made the excision of the fistula with simple suture of the aorta, subtotal esophagectomy, cervico-stoma and gastrostomy, with good postoperative evolution. After 4 months the digestive transit is restored by esophagoplasty with tubulized stomach placed behind the sternum. The diagnostic and @entity34 encountered in these kind of cases need to consider also an @entity1727 diagnosis, especially for the cases with Chiari triad (mild @entity158 , sentinel digestive @entity548 and exsanguination). The Blakemore tube can save @entity1 's life by ensuring temporary hemostasis and allowing the time for a definitive surgical intervention. The subtotal esophagectomy with cervicostoma and feeding gastrostomy, followed after few months by a esophageal reconstruction , is a solution for this extreme severe cases.
