Korean J Gastrointest Endosc.  2004 Jul;29(1):13-16.

A Case of Gastropericardial Fistula as a Complication after Esophagectomy with Esophagogastrostomy for Esophageal Cancer

• Son DK
• Kim JK
• Chung JS
• Jo DH
• Kim HK
• Park SH
• Han JY
• Chung KW
• Sun HS

Abstract

The gastric pedicle is commonly used for the reconstruction following the resection of esophageal cancer. We recently experienced a case in which gastric ulcer occurred eighteen months postoperatively. A 60 year-old man complaining of chest pain, dry cough, mild fever and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy because of esophageal cancer. Chest X-ray and CT scan showed pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach pedicle and the pericardium. Upper GI endoscopy showed beating heart through the fistulous opening. The patient expired with sepsis on the twenty second days after an emergent operation. Gastropericardial fistula caused by a peptic ulcer perforation after the esophgectomy and esophagogastrostomy operation is a very rare complication and brings a fatal result. Early detection using the chest radiography, electrocardiogram, echocardiography, upper GI study and physical examination, and an immediate treatment are therefore mandatory.

Keyword

Gastropericardial fistula; Esophageal cancer operation

MeSH Terms

Chest Pain
Chills
Cough
Echocardiography
Electrocardiography
Emergency Service, Hospital
Endoscopy
Esophageal Neoplasms*
Esophagectomy*
Fever
Fistula*
Heart
Humans
Middle Aged
Peptic Ulcer Perforation
Pericardium
Physical Examination
Pneumopericardium
Radiography
Sepsis
Stomach
Stomach Ulcer
Thorax
Tomography, X-Ray Computed