Aortogastric Fistula Due to a Penetrating Atherosclerotic Aortic Ulcer

Ann Vasc Surg. 2015 Nov;29(8):1659.e21-5. doi: 10.1016/j.avsg.2015.06.080. Epub 2015 Aug 22.


Penetrating aortic ulcer (PAU) is an atherosclerotic lesion with ulceration that penetrates the internal elastic lamina of the aortic wall. PAUs are classified as a category of acute aortic syndrome and have a reported rupture rate of up to 38%. To our knowledge, there is no prior published report of a PAU causing an aortogastric fistula. With the goal of raising awareness of this potentially catastrophic complication, we present herein a case of a PAU that ruptured into the gastric fundus, resulting in massive bleeding. The diagnosis was confirmed by computed tomography angiography, and thoracic endovascular aortic repair was used to control bleeding. Unfortunately, the patient did not survive the severe hypovolemic shock.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Diseases / complications*
  • Aortic Diseases / diagnosis
  • Aortic Diseases / surgery
  • Atherosclerosis / complications*
  • Atherosclerosis / diagnosis
  • Atherosclerosis / surgery
  • Gastric Fistula / diagnosis*
  • Gastric Fistula / etiology*
  • Gastric Fistula / surgery
  • Humans
  • Male
  • Vascular Fistula / diagnosis*
  • Vascular Fistula / etiology*
  • Vascular Fistula / surgery