Peptic-Ulcer-Induced Aortoenteric Fistula

A 71-year-old woman with a remote history of esophagogastric resection for malignancy developed abdominal pain, nausea and vomiting. She died of shock 15 days after admission, during which time clinical investigation failed to reveal recurrent tumor or an ulcer. The autopsy revealed massive exsanguination secondary to a peptic-ulcer-induced aortoenteric fistula (AEF). The ulcer involved the third portion of the duodenum, was chronic, and complicated by growth of fungus. We review the literature on peptic-ulcer-related AEF.