Esophagoatrial fistula.

The author describes a case of esophagoatrial fistula--an extremely rare condition. A 79-year-old-man had had epigastric pain for 4 weeks. Physical and roentgenographic examinations disclosed atrial fibrillation with a systolic murmur and an ulcer of the lower esophagus which, on histologic examination, was benign. No specific treatment was recommended. The patient died suddenly 3 months later from massive gastrointestinal hemorrhage which, at autopsy, was found to be due to an esophagoatrial fistula. A review of the literature showed that this case differed from others previously reported in that the duration of symptoms up to the time of death was only 4 months and the patient had no embolism.