Perforation of a benign gastric ulcer into the subdiaphragmatic aorta

A patient in whom a benign gastric ulcer perforated into the subdiaphragmatic aorta is reported. This is the second such case to be documented and the first to be reported in the English literature. Previous gastroesophageal surgery, regional radiation therapy, ulcerogenic medications, and endocrinopathies seem to be contributing factors to the potential of benign gastric and esophageal ulcers to perforate into the pericardium, left atrium, left ventricle thoracic or abdominal aorta. This complication is almost always lethal. It is concluded that peptic disease in patients with these contributing factors warrants aggressive treatment.