title: Non-traumatic perforation of gastric ulcer in a hiatal hernia to the pericardium.
abstract: A patient with ulcer in a hiatal hernia with perforation to the pericardial sac is reported. The symptoms and signs of non-traumatic perforation from esophagus or stomach to the pericardium or heart are described on the basis of a brief review of the literature. A prominent feature of our patient was long-standing pain in the left shoulder. We suggest that this symptom may be a warning of threatening pericardial perforation.
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006548:Hernia, Diaphragmatic / Q000150:complications*; D006551:Hernia, Hiatal / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology*; D010496:Pericardium / Q000473:pathology*; D012782:Shoulder; D013276:Stomach Ulcer / Q000150:complications