Khaled Sherif Ali Arvandi Leigh Ann Jenkins

Abstract

Gastropericardial fistula is an acquired disorder that is associated with a high mortality rate. It is a rare complication of laparoscopic surgery for reflux disease and thoracic procedures. A 74-year-old lady with history of gastroesophageal reflux disease (GERD) and surgically repaired hiatal hernia presented with history of chronic dyspnea and cough. Physical examination was normal apart of a pericardial rub. Laboratory data showed leukocytosis and the chest X-ray showed a large left-sided soft mass. As result of the mass on chest x ray, chest and abdominal CT scan was done and showed large pericardial effusion with hiatal hernia and gastro-pericardial connection. Gastropericardial fistula is an uncommon complication but it has very high mortality rate. Among causes that result in this condition, hiatal hernia and esophagogastric surgery have been the most frequently reported. The occurrence of post-operative gastropericardial fistula is induced by the perihiatal scarring. In addition, recurrence of hiatal hernia or migration of the surgical wrap may also favor occurrence of fistulae. For gastropericardial fistula, contrast media-enhanced traditional examinations are the cornerstone of diagnosis. Abdominal CT may reveal the fistula. Surgical correction is the most effective form of treatment.

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Keywords

GERD, gastropericardial fistula, hiatus hernia, pericardial effusion

References
1. Kim WJ, Choi EJ, Oh YW, Kim KT, Kim CW. Gastropericardial fistula-induced pyopneumo-pericardium after esophagectomy with esophagogastrectomy. Ann Thorac Surg 2011; 91(1):e10–1.
2. Chauhan A, Perry I, Veitch A, Li P, Rattehalli D, Brookes MJ. Gastropericardial fistula: a potential role for conservative treatment. Eur J Gastroenterol Hepatol 2012; 24(11):1341–1343.
3. Shackelford RT. Hydropneumopericardium. JAMA 1931; 96:187–191.
4. Pessaux P, Arnaud JP, Delattre JF, Meyer C, Baulieux J, Mosnier H. Laparoscopic antireflux surgery: five-year results and beyond in 1340 patients. Arch Surg 2005; 140(10):946-51.
5. Kato T, Mori T, Niibori K. A case of gastropericardial fistula of a gastric tube after esophagectomy: a case report and review. World J Emerg Surg 2010; 5:20.
6. Tang CP, Wang YW, Shiau YT, Lee RC, Lan KH, Chao Y. Gastropericardial fistula and Candida albicans pericarditis: a rare complication of gastric adenocarcinoma treated with radiation and chemotherapy. J Chin Med Assoc 2009; 72(7):374-378.
How to Cite
Sherif, K., Arvandi, A., & Jenkins, L. A. (2016). Gastropericardial fistula, uncommon complication for common surgical procedure. Archive of Clinical Cases, 3(1), Arch Clin Cases 2016; 3(1):1-4. https://doi.org/10.22551/2016.10.0301.10060
Section
Case Reports

How to Cite

Sherif, K., Arvandi, A., & Jenkins, L. A. (2016). Gastropericardial fistula, uncommon complication for common surgical procedure. Archive of Clinical Cases, 3(1), Arch Clin Cases 2016; 3(1):1-4. https://doi.org/10.22551/2016.10.0301.10060