Summary

The authors report a case of an aorto-oesophageal fistula presenting in a patient undergoing investigation for possible oesophageal malignancy who underwent multiple oesophageal biopsies. A 73-year-old gentleman underwent endoscopic biopsy of an oesophageal lesion. Histology showed only inflammatory changes, endoscopy was repeated and again biopsy showed only inflammatory changes. The patient then presented with severe haematemesis, which was shown by CT angiogram to be due to an aorto-oesophageal fistula. This was treated with endovascular stenting, and the patient recovered well. Sequential imaging has shown gradual resolution of the submucosal swelling and lymphadenopathy, excluding the possibility of underlying oesophageal malignancy. This is the first reported case of aorto-oesophageal fistulation as a complication of endoscopic oesophageal biopsies. Aorto-oesophageal fistula is an uncommon but potentially life-threatening cause of haematemesis. It is a potential complication of endoscopic oesophageal biopsy.