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Sudden onset haematemesis occurred in a 52-year old male with oesophageal cancer. Computed tomography showed an aorto-oesophageal fistula with contrast extravasation from the aorta. Thoracic endovascular aortic repair with stent graft was done. The haematemesis stopped postoperatively, but follow-up images (Fig. 1) showed persistent contrast extravasation. The patient died of another episode of massive haematemesis 1 week later.

Aorto-oesophageal fistula with upper gastrointestinal tract intramural haematoma in an oesophageal cancer patient