, 8:137 | Cite as

Gastropericardial fistula resulting from ulcerative perforation of the reconstructed gastric tube after surgery for esophageal cancer

  • Hironori YamaguchiEmail author
  • Masahiro Kato
  • Noriko Tada
  • Koji Murono
  • Hironori Ishigami
  • Shoichi Kaisaki
  • Joji Kitayama
  • Hirokazu Nagawa
Case Report


Gastropericardial fistulae are rare and may cause fatal complications such as acute purulent carditis and cardiac tamponade. The present report describes a case of a gastropericardial fistula caused by a peptic ulcer perforating a retrosternal reconstructed gastric tube 2 years after subtotal esophagectomy for esophageal cancer. Surgical intervention involved left thoracotomy, pericardium fenestration, and drainage of the pericardium and left thoracic cavity. The patient suffered postoperative complications including septic shock, acute respiratory distress syndrome, and cardiac insufficiency; however, he recovered after successful surgical intervention. In this case, the withdrawal of proton pump inhibitors and the patient’s sustained drinking habit after esophageal replacement surgery may have caused peptic ulcers in the gastric tube. Early diagnosis and surgical treatment of gastropericardial fistulae are essential to avoid fatal complications.


Gastric tube ulcer Gastropericardial fistula Purulent pericarditis Esophageal replacement Esophageal cancer 


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Copyright information

© The Japan Esophageal Society and Springer 2011

Authors and Affiliations

  • Hironori Yamaguchi
    • 1
    Email author
  • Masahiro Kato
    • 1
  • Noriko Tada
    • 1
  • Koji Murono
    • 1
  • Hironori Ishigami
    • 1
  • Shoichi Kaisaki
    • 1
  • Joji Kitayama
    • 1
  • Hirokazu Nagawa
    • 1
  1. 1.Department of Surgical OncologyThe University of Tokyo HospitalTokyoJapan

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