Death Related to Fistulas Involving the Gastrointestinal and Cardiovascular Systems

Gastrointestinal tract fistulas are relatively uncommon and can be congenital or acquired. Acquired fistulas which communicate with the cardiovascular system are of particular concern, as they may be associated with significant morbidity and mortality. When found at autopsy, gastrointestinal fistulas should be thoroughly documented. Sudden and unexpected deaths with a history of gastrointestinal or cardiovascular surgery and a recent history of gastrointestinal bleeding or fever of an undetermined etiology should be approached with a high index of suspicion by medical examiners and signal a need for more careful dissection and documentation. This study reports on three deaths related to acquired, postsurgical fistula formation involving the gastrointestinal and cardiovascular systems.