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.