| Summary points: | A 59-year-old male presents with odynophagia and sharp pain retrosternally after eating fish the previous day. He is discharged with an outpatient barium swallow, and presents again 5 days later with frank haematemesis and malaena. Computed tomography angiogram, percutaneous endoscopic gastrostomy, and aortic repair are described; images provided. The authors review the relevant literature and discuss the diagnostic criteria and management of aortoesophageal fistulas secondary to foreign bodies. |