GASTRO-AORTIC FISTULA - AN UNCOMMON COMPLICATION OF NISSEN FUNDOPLICATION

We report a case of and review the literature concerning primary gastr o-aortic fistula secondary to erosion of a gastric ulcer into the thor acic aorta in a patient with a previous Nissen fundoplication. Treatme nt consisted of excision of the fistula with closure of the gastric an d aortic defects. This rare cause of upper gastrointestinal bleeding i s life threatening, and a high level of suspicion is necessary to make the diagnosis and initiate early, aggressive surgical treatment.