Exsanguination from esophageal rupture of an atherosclerotic aortic aneurysm in a patient with treated tuberculosis

An elderly man with previous tuberculosis exsanguinated from esophageal rupture of an atherosclerotic thoracic aneurysm. Because the patient refused angiography, the source of bleeding was discovered only at autopsy. Selected clinical and pathologic aspects of the case are discussed in relation to the different causes of thoracic aortic aneurysms. Because these lesions have a grave prognosis, the need for timely diagnostic evaluation and aggressive surgical management is emphasized.