Gastropericardial fistula as a complication in a refractory gastric ulcer after esophagogastrostomy with gastric pull-up.
A gastropericardial fistula, defined as penetration of a gastric lesion into the pericardium, is a rare occurrence. Such a fistula is usually associated with a huge ulcer in the gastric fundus, an ulcer within a hiatus hernia, a history of esophagogastric surgery, the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs), or Zollinger-Ellison syndrome. The patient in this case presented with shoulder pain and melena, caused by a gastropericardial fistula that had occurred as a late complication of postoperative esophagogastrostomy and a refractory gastric ulcer. Despite the severity of the condition, the patient showed great improvement after medical treatment and the fistula was cured at the end.
Park
Semi
S
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Kim
Jie-Hyun
JH
Lee
Yong Chan
YC
Chung
Jae Bock
JB
D016629:Esophagectomy / Q000379:methods*; D005747:Gastric Fistula / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology*; D013276:Stomach Ulcer / Q000150:complications* / Q000601:surgery*