Fatal aorto-esophageal fistula detected on postmortem computed tomography angiography

• The aorto-esophageal fistula is a rare and mostly life threatening event, mostly first diagnosed postmortem.
• As part of the postmortem examination the postmortem computed tomography including an angiography is a very helpful tool for the forensic pathologist to find the right diagnosis.
• In this case the postmortem computed tomography angiography shows the diagnosis prior to the autopsy and allowed an exact dissection during the conventional autopsy.

The aorto-esophageal fistula (AEF) is a rare life threatening event, mostly first diagnosed postmortem during the autopsy, although an accurate diagnosis can still be complicated. The postmortem computed tomography (PMCT) including an angiography (PMCTA) is a helpful tool to find the correct diagnosis. This is a case of a fatal gastro-intestinal hemorrhage that occurred due to an aorto-esophageal fistula, diagnosed prior to the conventional autopsy by PMCTA.