Rupture of a thoracic aneurysm in the left bronchus

Aortobronchic fistula is a very unusual complication of thoracic aneurysm. We report the case of a 71-year old man with rupture of a thoracic aortic a neurysm in the left main bronchus. The patient had suffered a car crash fif teen years ago, without any evidence of aortic rupture at the time. Thereaf ter, he developed an aortic isthmic dilation (36 mm in diameter). The patie nt suffered from long standing pulmonary insufficiency and emphysema and wa s admitted several times on an urgent basis for acute dyspnea. During an ho spitalization for respiratory distress, he presented haemoptysis and left l ung hyperinflation secondary to partial fistulization and extrinsic compres sion of the main left bronchus. Isthmic aortic resection and prosthetic grafting was performed and the left main bronchus was closed by an autologous pericardial patch. Ten days late r, following an air-leak from the bronchial closure, a transposed latissimu s dorsi flap was used by the plastic surgeon to repair the defect. Neverthe less, the patient died from multisystemic failure six weeks later.