Massive Upper Gastrointestinal Hemorrhage Secondary to Aortoenteric Fistula.

Aortoenteric fistula (AEF) is an uncommon condition that can present with severe gastrointestinal bleeding. We report the case of a 70-year-old woman with small-cell lung carcinoma and a known abdominal aortic aneurysm who arrived in hemorrhagic shock after massive hematemesis. CT angiography revealed direct communication between the aorta and the duodenum, consistent with an AEF. Despite resuscitation measures, broad-spectrum antibiotics, and coordination with vascular surgery, her clinical condition deteriorated rapidly prior to transfer for operative treatment. The patient died within hours. This case illustrates the rapidly progressive nature of AEF presentations and reinforces the need for early recognition and coordinated management.