Rupture.UPTURE of the aorta into the gastro-intestinal tract is a rare occurrence and has a grave prognosis. Until recently, accurate diagnosis was of little consequence since specific surgical techniques were not widely available. However, the surgeons are now able to handle this emergency and successful operative management is being reported.1-5 The challenge is now for the clinician to increase his diagnostic accuracy. Several recent reports indicate this is possible.6,7 But unfortunately, the diagnosis of aortico-intestinal fistula remains exceedingly difficult, even when it is considered in the differential of gastrointestinal hemorrhage. Scrutiny of the reports on successfully managed cases reveals that some of them were unexpectedly discovered only at the time of laparotomy. Therefore, preoperative diagnosis is even less frequent than it is suggested. This paper reviews the case histories of four patients with aorticoduodenal rupture and three patients with aorticoesophageal rupture. It was hoped that this review would