{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:11:00Z","timestamp":1778217060127,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>An aortoesophageal fistula (AEF) following radical surgery for gastric cardia cancer is a rare and serious problem with a historically dismal prognosis. Diagnosing it was difficult because the patient did not show the typical set of symptoms and the initial digital subtraction angiography (DSA) failed to reveal the underlying pathology. Treatment involved a planned multi-specialty approach. First, emergency stent placement in the aorta (TEVAR) was performed to achieve hemostasis. Later, planned surgeries were performed including esophageal exclusion and then colonic interposition to rebuild the food passage. This combined method led to the patient surviving for over three years. This case underscores the necessity for clinicians to maintain a high index of suspicion for aorto-esophageal fistula (AEF), even when initial diagnostic evaluations are unremarkable. It also shows that TEVAR alone is often not enough and a carefully planned series of operations to control both bleeding and infection can lead to a favorable long-term outcomes.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1806417","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:43:38Z","timestamp":1778215418000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Aortoesophageal fistula after radical gastrectomy for cardia cancer: diagnostic problems and successful staged treatment"],"prefix":"10.3389","volume":"13","author":[{"given":"Kai","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"212","DOI":"10.17235\/reed.2023.9526\/2023","article-title":"Aorto-esophageal fistula secondary after thoracic endovascular aortic repair","volume":"115","author":"Aparicio-L\u00f3pez","year":"2023","journal-title":"Rev Esp Enferm Dig"},{"key":"B2","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1186\/s13256-024-04605-0","article-title":"Surgical repair of an aortoesophageal fistula after salvage thoracic endovascular aortic repair: a case report","volume":"18","author":"Uemura","year":"2024","journal-title":"J Med Case Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2002","DOI":"10.1016\/j.jtcvs.2020.06.035","article-title":"Repair of aortoesophageal fistula with homograft aortic replacement and primary esophageal closure","volume":"163","author":"Jeon","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12893-026-03489-9","article-title":"Successful rescue of a patient with aortoesophageal fistula secondary to anastomotic leak after esophagectomy","volume":"26","author":"Xue","year":"2026","journal-title":"BMC Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"102051","DOI":"10.1016\/j.jvscit.2025.102051","article-title":"Staged open surgical repair of an aortic esophageal fistula in the setting of an aortic dissection","volume":"12","author":"Thandra","year":"2026","journal-title":"J Vasc Surg Cases Innov Tech"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e415","DOI":"10.1016\/j.athoracsur.2022.02.026","article-title":"Combined minimally invasive treatment of delayed aortoesophageal fistula caused by fishbone","volume":"114","author":"Zhang","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.cireng.2022.06.039","article-title":"Aortoesophageal fistula after laparoscopic total gastrectomy","volume":"100","author":"Rigueiro L\u00f3pez","year":"2022","journal-title":"Cir Esp (Engl Ed)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1123305","DOI":"10.3389\/fcvm.2023.1123305","article-title":"Case report: aortoesophageal fistula-an extremely rare but life-threatening cardiovascular cause of hematemesis","volume":"10","author":"Wong","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"rjaf674","DOI":"10.1093\/jscr\/rjaf674","article-title":"Delayed presentation of aortoenteric fistula after esophagectomy","volume":"2025","author":"Shah","year":"2025","journal-title":"J Surg Case Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"223","DOI":"10.17235\/reed.2024.10397\/2024","article-title":"Rapid formation of aortoesophageal fistula complicated by mycotic thoracic aortic aneurysm secondary to infective endocarditis","volume":"117","author":"Setake","year":"2025","journal-title":"Rev Esp Enferm Dig"},{"key":"B11","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/j.jvscit.2021.04.001","article-title":"Aortoesophageal fistula treated with emergent thoracic stent grafting","volume":"7","author":"Kaushik","year":"2021","journal-title":"J Vasc Surg Cases Innov Tech"},{"key":"B12","doi-asserted-by":"publisher","first-page":"15266028241300403","DOI":"10.1177\/15266028241300403","article-title":"Thoracic endovascular aortic repair for the management of aorto-esophageal fistulae: a systematic review","author":"Wang","year":"2024","journal-title":"J Endovasc Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1186\/s13019-020-01293-x","article-title":"Surgical treatment for secondary aortoesophageal fistula","volume":"15","author":"Sugiyama","year":"2020","journal-title":"J Cardiothorac Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1111\/1759-7714.14446","article-title":"Three-stage approach for aortoesophageal fistula after Roux-en-Y esophagojejunostomy","volume":"13","author":"Dai","year":"2022","journal-title":"Thorac Cancer"},{"key":"B15","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1186\/s13019-023-02438-4","article-title":"Aortoesophageal fistula treated using one-stage total reconstruction: a case report from a high-volume center","volume":"18","author":"Lee","year":"2023","journal-title":"J Cardiothorac Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e45547","DOI":"10.1097\/MD.0000000000045547","article-title":"Aortoesophageal fistula following emergency thoracic endovascular aortic repair: 2 case reports and brief review","volume":"104","author":"Wen","year":"2025","journal-title":"Medicine (Baltimore)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1111\/vec.12998","article-title":"Lethal acute hemorrhage from an aortoesophageal fistula following endoscopy-assisted esophageal foreign body removal in a dog","volume":"30","author":"Rimer","year":"2020","journal-title":"J Vet Emerg Crit Care (San Antonio)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e29826","DOI":"10.1097\/MD.0000000000029826","article-title":"Role of gut microbiota in postoperative complications and prognosis of gastrointestinal surgery: a narrative review","volume":"101","author":"Shi","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1067\/j.cpradiol.2024.05.018","article-title":"Complications of thoracic endovascular aneurysm repair (TEVAR): a pictorial review","volume":"53","author":"Awiwi","year":"2024","journal-title":"Curr Probl Diagn Radiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e545","DOI":"10.1097\/SCS.0000000000011260","article-title":"Total approach to postoperative fistula after head and neck reconstruction","volume":"36","author":"Onoda","year":"2025","journal-title":"J Craniofac Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.29271\/jcpsp.2024.11.1374","article-title":"Modified double-tract reconstruction in gastrointestinal reconstruction after proximal gastrectomy","volume":"34","author":"Li","year":"2024","journal-title":"J Coll Physicians Surg Pak"},{"key":"B22","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1177\/17085381221140950","article-title":"Temporizing stent graft for aortoenteric fistula with massive gastrointestinal hemorrhage","volume":"32","author":"Patel","year":"2024","journal-title":"Vascular"},{"key":"B23","doi-asserted-by":"publisher","first-page":"775536","DOI":"10.3389\/fcvm.2021.775536","article-title":"Case report: dynamic changes in hemodynamics during the formation and progression of intracranial aneurysms","volume":"8","author":"Zhai","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e20200179","DOI":"10.1590\/1677-5449.200179","article-title":"Intraoperative endoprosthesis customization for repair of an aortoenteric fistula in an emergency context: a case report","volume":"20","author":"Carrijo","year":"2021","journal-title":"J Vasc Bras"},{"key":"B25","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.avsg.2023.10.028","article-title":"Revascularization and digestive tract repair in secondary aortoenteric fistula using a single-Center in situ revascularization strategy","volume":"101","author":"Akamatsu","year":"2024","journal-title":"Ann Vasc Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e82361","DOI":"10.7759\/cureus.82361","article-title":"Aortoenteric fistula: a rare cause of gastrointestinal bleeding","volume":"17","author":"Ferreira","year":"2025","journal-title":"Cureus"},{"key":"B27","doi-asserted-by":"publisher","first-page":"132","DOI":"10.4166\/kjg.2021.006","article-title":"Primary aortoduodenal fistula causes massive melena: a case report","volume":"77","author":"Kim","year":"2021","journal-title":"Korean J Gastroenterol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1080\/00365521.2022.2062258","article-title":"Out of sight for the endoscopist? Gastrointestinal bleeding after aortic repair","volume":"57","author":"Busch","year":"2022","journal-title":"Scand J Gastroenterol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e75960","DOI":"10.7759\/cureus.75960","article-title":"Aspergillus Species as a rare cause of primary mycotic aneurysm with aortoenteric fistula","volume":"16","author":"Alshubaily","year":"2024","journal-title":"Cureus"},{"key":"B30","doi-asserted-by":"publisher","first-page":"4053","DOI":"10.1097\/MS9.0000000000000909","article-title":"Digestive hemorrhage and fever as a result of a double secondary aortoenteric fistula following the repair of a juxtarenal abdominal aortic aneurysm and an infection of the aortobifemoral bypass graft: a case report","volume":"85","author":"Abu Jheasha","year":"2023","journal-title":"Ann Med Surg (Lond)"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1806417\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:44:00Z","timestamp":1778215440000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1806417\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":30,"alternative-id":["10.3389\/fcvm.2026.1806417"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1806417","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"article-number":"1806417"}}