<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452025000200047</article-id>
<article-id pub-id-type="doi">10.1159/000539913</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Aortoesophageal Fistula Mimicking Dieulafoy Disease: A Case Report]]></article-title>
<article-title xml:lang="pt"><![CDATA[Fístula Aortoesofágica que mimetiza Doença de Dieulafoy: Descrição de um caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pacheco]]></surname>
<given-names><![CDATA[Tatiana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Costa-Moreira]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monteiro]]></surname>
<given-names><![CDATA[Sara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Luísa Barros Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar do Tâmega e Sousa Gastroenterology Department ]]></institution>
<addr-line><![CDATA[Pena&#64257;el ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<volume>32</volume>
<numero>2</numero>
<fpage>47</fpage>
<lpage>50</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452025000200047&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452025000200047&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452025000200047&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Aortoesophageal &#64257;stula (AEF) is a rare and potentially fatal cause of upper gastrointestinal bleeding. The classic Chiari&#8217;s triad of symptoms and typical endoscopic &#64257;ndings are not present in all patients, making diagnosis challenging.  Case Presentation:  An 86-year-old man was admitted to the emergency room for melena and hematemesis with hemodynamic instability. He had a previous hospitalization for cardioembolic stroke complicated by hematemesis of unknown etiology after initiation of anti-coagulation (which was suspended), being discharged on aspirin. His medical history also included hypertension, diabetes, ischemic heart disease, and prostate cancer. On upper endoscopy, no lesions were found, despite the presence of a large non-mobilizable clot in the gastric fundus. He was admitted to the intensive care unit, and, on the next day, reassessment esophagogastroduodenoscopy was normal. On the eighth day of hospitalization, the patient presented with hemorrhagic shock due to new-onset hematemesis. Upper endoscopy revealed an esophageal 10-mm non-ulcerated mucosal depression with a visible vessel at 20 cm from the incisors, closed with 3 hemoclips. Thoracic CT angiography showed a brachiocephalic trunk aneurysm with aortoesophageal &#64257;stulization. He was deemed unsuitable for endovascular or surgical treatment. About 2 months later, the patient was admitted to the emergency room in cardiorespiratory arrest following an episode of hematemesis at home.  Discussion:  This report highlights the diagnostic and therapeutic complexity of AEF. Endoscopic treatment can be the main therapy in patients without indication for vascular intervention. The purpose was to palliate new bleeding episodes, maintaining a very poor prognosis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: A fístula aortoesofágica (FAE) é uma causa rara e potencialmente fatal de hemorragia digestiva alta. A tríade clássica de sintomas de Chiari e os achados endoscópicos típicos não estão presentes em todos os doentes, o que torna o diagnóstico desa&#64257;ante.  Apresentação do Caso: Um  homem de 86 anos foi admitido na sala de emergência por melenas e hematemeses com instabilidade hemodinâmica. Apresentou internamento recente por AVC isquémico cardioembólico complicado por hematemeses de etiologia indeterminada após início de hipocoagulação (que foi suspensa), tendo alta sob aspirina. Acresciam os antecedentes de hipertensão, diabetes, cardiopatia isquémica e neoplasia prostática. Na endoscopia digestiva alta (EDA) não foram encontradas lesões, apesar de coágulo gigante não mobilizável no fundo gástrico. Foi internado em Unidade de Cuidados Intensivos, tendo repetido EDA no dia seguinte que foi normal. No oitavo dia de internamento, apresentou-se com choque hemorrágico devido a novo episódio de hematemeses. A EDA revelou, aos 20 cm, uma depressão da mucosa não ulcerada de 10 mm com vaso no leito, encerrada com 3 hemoclips. O AngioTC torácico mostrou aneurisma do tronco braquicefálico com &#64257;stulização aortoesofágica. O doente não era candidato a tratamento endovascular ou cirúrgico. Cerca de dois meses depois, o doente foi admitido na sala de emergência em paragem cardiorrespiratória após episódio de hematemeses no domicílio.  Conclusão:  Este caso destaca a complexidade diagnóstica e terapêutica da FAE. O tratamento endoscópico pode constituir a terapêutica principal nos doentes sem indicação para intervenção vascular. O objetivo é a paliação de novos episódios de hemorragia, mantendo-se o péssimo prognóstico.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Esophageal &#64257;stula]]></kwd>
<kwd lng="en"><![CDATA[Aortic diseases]]></kwd>
<kwd lng="en"><![CDATA[Gastrointestinal bleeding]]></kwd>
<kwd lng="en"><![CDATA[Computed tomography angiography]]></kwd>
<kwd lng="en"><![CDATA[Aged 80 and over]]></kwd>
<kwd lng="pt"><![CDATA[Fístula esofágica]]></kwd>
<kwd lng="pt"><![CDATA[Doenças da aorta]]></kwd>
<kwd lng="pt"><![CDATA[Hemorragia gastrointestinal]]></kwd>
<kwd lng="pt"><![CDATA[Angiogra&#64257;a por tomogra&#64257;a computadorizada]]></kwd>
<kwd lng="pt"><![CDATA[Idosos]]></kwd>
<kwd lng="pt"><![CDATA[80 anos ou mais]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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