Aortoesophageal fistula: report of an unusual case.

We report herein the case of a patient with an aortoesophageal fistula (AEF) who was managed successfully by surgery. A 5-mm oval, well circumscribed aortic perforation just above the orifice of the celiac axis and a 4-mm defect in the esophagus were primarily closed, and an omental flap was placed between the aorta and the esophagus. No definite etiology could be determined. Our experience of this case suggests that primary closure for defects in both the aorta and the esophagus is the best option when the defects are small, and that the possibility of an AEF must be considered in patients with midthoracic pain or hematemesis, even if there is no history of thoracic aortic aneurysm, foreign body ingestion, trauma, or esophageal disease.