Gastro-aortic fistula: an uncommon complication of Nissen fundoplication.

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