Aortoesophageal fistula. Review of clinical, radiographic, and endoscopic features.

Primary aortoesophageal fistula is a rare cause of severe and often fatal gastrointestinal bleeding. The classic diagnostic triad consists of midthoracic pain and sentinel hemorrhage, followed by fatal exsanguination. A prompt, definitive diagnosis at the time of the initial bleeding episode is essential for timely, life-saving surgery. Any combination of low-grade, intermittent hematemesis, with midthoracic chest pain, dysphagia, or a mediastinal mass, should alert the physician to this diagnosis, and an aggressive diagnostic and therapeutic approach. In this article, we report a case of aortoesophageal fistula and present photographs.