Aorto-oesophageal fistula: An unusual cause of upper gastrointestinal bleeding

Abstract

We report a case of a 35-year-old man who pre- sented with haematemesis, chest pain and a very high fever following the swallowing of a fishbone five days previously. He was correctly diagnosed as having a mediastinitis but had an exsanguinating haematemesis and died within 24 hours of arrival in hospital. Post mortem revealed mediasinitis and an aorto-oesophageal fistula. The difficulty in making the diagnosis of this condition and the often- resulting catastrophic haemorrhage that occurs are discussed. It is a condition that should be considered in a patient presenting with fresh haematemesis and a history of ingestion of a foreign body five to seven days previously