A 60-year-old patient underwent replacement of an abdominal aortic aneurysm and developed an aortoileal fistula at the distal anastomosis nearly five years later and an aortogastric fistula at the proximal anastomosis nearly ten years later. The occurrence of an aortogastric fistula complicating aortic graft has not been reported previously, to
the authors' knowledge. This is also possibly the first known instance of a patient having two fistulas between the aorta and the alimentary tract, both of which were successfully repaired following massive gastrointestinal hemorrhage. The use of the direct suture repair for such fistulas is encouraged in selected, noninfected patients.