A case of progressive systemic sclerosis died from the perforation of an esophageal ulcer to the aorta.

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In this report, we described a patient with progressive systemic sclerosis (PSS) died from massive hematoemesis due to an aortoesophageal fistula.This patient was a 71 years old woman. She had Raynaud's phenomenon since 20 years before and sclerodactyly and swallowing disturbance were gradually developed. She admitted to the hospital because of upper abdominal pain and loss of appetite. On the 10th hospital day, she fell into shock with severe back pain and died from the following massive hematoemesis. In the autopsy, an esophageal ulcer was present in the dilated lower esophagus and a hole of 1mm in diameter reached to the aorta.Aortoesophageal fistula from reflux esophagitis was extremely rare. In this case, it was seemed that fistula formation was caused by fibrosis in the subcutaneous tissue and muscle atrophy of lower esophagus.