Uncommon cause of upper gastrointestinal bleeding

Abstract

Penetrating aortic atherosclerotic ulcers have been recognised as an entity among the acute aortic syndromes with potentially fatal outcome. We describe the case of a patient presenting with epigastric pain who died as a result of a thoracic aorta penetrating atherosclerotic ulcer complicated by intramural hematoma of the middle esophagus which has ruptured to the esophagus as an aortoesophageal fistula leading to exsanguination. To our knowledge, only two similar cases were reported and ours is the third such report.