CASE REPORT article
Front. Surg.
Sec. Vascular Surgery
Penetrating Aortic Ulcer Following Endoscopic Dilatation of Esophageal Anastomotic Stenosis
Provisionally accepted
- The First People’s Hospital of Kunshan, Suzhou,, Jiangsu, China
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Background: Endoscopic balloon dilation serves as the first-line treatment for anastomotic strictures after esophagectomy. While generally safe, the procedure can, in rare instances, lead to severe vascular complica-tions. Case Presentation: A 64-year-old male with a prior history of esophagectomy for cancer presented with dysphagia due to an anastomotic stricture. Shortly after undergoing endoscopic balloon dilation, he devel-oped hoarseness. Computed tomography (CT) identified a penetrating aortic ulcer (PAU) with contained rupture and an associated hematoma compressing the left recurrent laryngeal nerve, consistent with Ortner's syndrome. The patient was successfully managed with emergent thoracic endovascular aortic repair (TEVAR). At the three-month follow-up, the aortic stent remained, and his hoarseness had significantly im-proved. Conclusion: This rare case of a PAU and Ortner's syndrome following endoscopic dilation underscores the critical importance of vigilance for life-threatening vascular injuries after seemingly routine procedures. It highlights the necessity of considering such complications in the differential diagnosis of post-procedural symptoms and demonstrates the efficacy of endovascular repair as a definitive treatment option.
Keywords: Penetrating aortic ulcer, Ortner's syndrome, Endoscopic balloon dilation, Esophageal anastomotic stricture, Endovascular repair, Iatrogenic vascular injury, Esophagectomy complications
Received: 12 Jul 2025; Accepted: 19 Nov 2025.
Copyright: © 2025 Yang, Wang and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qing-Hua Wang, ksph_wqh@sina.com
Wei Han, hans64@126.com
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