title: Case report: benign gastric ulcer erosion leading to a gastropericardial fistula in a patient with no known risk factors.
abstract: A 53-year-old homeless male presented to the emergency department with sudden onset chest pain and was found to have a large pneumopericardium on chest X-ray. The patient had no history of surgery, hiatal hernia, or ulcer disease. A contrast-enhanced computed tomography scan demonstrated the pneumopericardium and raised concern for possible gastropericardial fistula from a benign gastric ulcer. An esophagogastroduodenoscopy confirmed the fistula, as did surgery, and intraoperatively vegetable particular matter was removed from the anatomic space continuous with the pericardium.
authors.affiliation: Stanford Hospital & Clinics, Department of Radiology, 300 Pasteur Dr., H1307 MC 5621, Stanford, CA 94305. Electronic address: jjreicher@gmail.com.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Reicher
authors.affiliation: Stanford Hospital & Clinics, Department of Radiology, 300 Pasteur Dr., H1307 MC 5621, Stanford, CA 94305.
authors.forename: Robert
authors.initials: R
authors.lastname: Mindelzun
mesh_terms: D000437:Alcoholism / Q000150:complications; D003287:Contrast Media / Q000737:chemistry; D005747:Gastric Fistula / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging; D011026:Pneumopericardium / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D012307:Risk Factors; D013276:Stomach Ulcer / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Gastric ulcer; Gastropericardial fistula; Pneumopericardium