Aortopulmonary fistula due to failed graft for aortic aneurysm

Hemoptysis originating from an aortobronchial fistula is uncommon. This fistulous connection between the aorta and the lung usually results from a preexisting thoracic-aortic aneurysm, and is uniformly fatal when left untreated. However, with early diagnosis the survival rate exceeds 80%. The case of an aortobronchial fistula in a young alcoholic, 2 years after aortic aneurysmectomy, is presented. He was admitted with symptoms suggesting upper gastrointestinal bleeding, allegedly related to alcohol abuse. He died of a sudden, massive hemoptysis 5 days after admission. An aortobronchial fistula was found on autopsy. To diagnose aortobronchial fistula, a high index of suspicion is necessary. It should be considered in patients with hemoptysis after repair of a thoracic aneurysm.