Gastro-right ventricular fistula: a deadly complication of a gastric pull-through.
A 70-year-old patient presented with melena, dyspnea, and generalized weakness. An endoscopy revealed a deep ulcer with a pulsatile clot in the intrathoracic gastric tube that had been previously constructed for esophageal replacement. Shortly thereafter, the patient died of exsanguination secondary to a fistula between the stomach and the right ventricle. This complication presents a unique but deadly cause of gastrointestinal bleeding that mandates swift diagnosis and immediate surgical correction.
Rana
Zeshan A
ZA
Christiana Care Health System, Center for Heart and Vascular Health, Newark, Deleware 19718, USA. zrana1@gmail.com
Hosmane
Vinay R
VR
Rana
Nabeel R
NR
Emery
Donald L
DL
Goldenberg
Edward M
EM
Gardner
Timothy J
TJ
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D004935:Esophageal Diseases / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D004947:Esophagus / Q000601:surgery; D017809:Fatal Outcome; D005747:Gastric Fistula / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006331:Heart Diseases / Q000209:etiology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D012421:Rupture / Q000601:surgery; D013270:Stomach / Q000601:surgery*