Objective:

To report a rare case of aortoesophageal fistula (AEF) following radical gastrectomy for gastric cardia cancer, emphasizing its implications for clinical practice and the need for heightened awareness among clinicians.

Key Findings:

• AEF is a rare but life-threatening complication with a high mortality rate, often exceeding 50% if not managed promptly.
• Initial diagnostic evaluations may yield false negatives, necessitating repeat imaging to confirm suspicion.
• A multi-modal, staged treatment approach can lead to favorable long-term outcomes, as evidenced by the patient's survival.

Interpretation:

Clinicians should maintain a high index of suspicion for AEF despite unremarkable initial imaging results, and a comprehensive treatment strategy, including both endovascular and surgical interventions, is essential for improving prognosis.

Limitations:

• The case is based on a single patient experience, limiting generalizability to broader populations.
• Diagnostic challenges may vary based on individual patient circumstances, and potential biases in imaging interpretation should be considered.

Conclusion:

This case emphasizes the importance of vigilance in monitoring for AEF and the effectiveness of a coordinated, multi-disciplinary treatment plan in managing such complex cases, highlighting the need for early detection and intervention.