Kielhofner Marcia A. M.D.; Schnell, Gregory M.D.; Schubert, Timothy T. M.D.; Kebede-Daniels, Daniel M.D.Journal of Clinical Gastroenterology: December 1987 Case Studies: PDF Only Buy Abstract An 83-year-old woman with no history of vascular surgery presented with a fatal upper gastrointestinal bleed from an aortogastric fistula secondary to a penetrating gastric ulcer. The fistula was between the thoracic aorta and the gastric ulcer in a hiatus hernia. On autopsy, a discrete 1-cm ulcer had perforated into the otherwise normal thoracic aorta. Aortogastric fistula involving the thoracic aorta and a gastric ulcer is rare in the absence of vascular graft surgery or aneurysm. We review the pertinent literature. © Lippincott-Raven Publishers.