Successful treatment of aortogastric fistula after esophagectomy

Aortogastric fistula is a rare and lethal complication after esophagectomy. We report a case of an aortogastric fistula due to a peptic ulcer after esophagectomy for esophageal carcinoma, in which treatment with surgery and endovascular stent graft repair was successful. A 67-year-old woman underwent esophagectomy for esophageal carcinoma and reconstruction with a gastric tube through the posterior mediastinal route. Eleven years later, she experienced massive hematemesis and severe shock due to an aortogastric fistula, although there was no evidence of cancer recurrence. The fistula was obliterated surgically and the perforated aorta was directly closed. However, a pseudoaneurysm located at the closure site on the aortic wall developed postoperatively. An endovascular thoracic aortic stent graft was placed successfully, and she was discharged after intensive care. Thus, we present the very rare case of an aortogastric fistula formed following esophagectomy that was successfully treated with surgery and endovascular stent graft repair.