Author:
Kato Takehito,Mori Takahiro,Niibori Koki
Abstract
Abstract
A 65-year-old man who had received an esophagectomy 10 years earlier was admitted to our hospital for right chest pain. Preoperative examinations showed pneumopericardium, a retrosternal gastric tube, and an active gastric tube ulcer. We diagnosed gastropericardial fistula of the gastric tube ulcer. Emergency surgery included lavage and drainage of the pericardial cavity and plombage of the rectus abdominis muscle flap to the posterior space of the gastric tube. Total parental nutrition and/or enteric nutrition were provided. Due to minor leakage from the ulcer, the patient could start oral intake on the postoperative 49th day, and was discharged from the hospital on the postoperative 86th day after physical rehabilitation. He has been free from complications for more than 33 months after surgery. Here, we review the literature and discuss the etiology and treatment of choice for this rare yet lethal complication in the follow-up after esophagectomy.
Publisher
Springer Science and Business Media LLC
Subject
Emergency Medicine,Surgery
Reference39 articles.
1. Shima I, Kakegawa T, Fujita H: Gastropericardial and gastrobrachiocephalic vein fistulae caused by penetrating ulcers in a gastric pedicle following esophageal cancer resection: a case report. Jpn J Surg. 1991, 21: 96-9. 10.1007/BF02470872.
2. Takemura M, Higashino M, Osugi H, Tokuhara T, Fujiwara K, Kinoshita H: Five cases of peptic ulcer of gastric tube after radical esophagectomy for esophageal carcinoma and analysis of Helicobacter pylori infection at gastric tube. Nippon Kyobu Geka Gakkai Zasshi. 1997, 45: 1992-7. (in Japanese).
3. Katsoulis IE, Veloudis G, Exarchos D, Yannopoulos P: Perforation of a gastric tube peptic ulcer into the thoracic aorta. Dis Esophagus. 2001, 14: 76-8. 10.1111/j.1442-2050.2001.00156.x.
4. Mochizuki Y, Akiyama S, Koike M, Kodera Y, Ito K, Nakao A: A peptic ulcer in a reconstructed gastric tube perforating the thoracic aorta after esophageal replacement. Jpn J Thorac Cardiovasc Surg. 2003, 51: 448-51. 10.1007/BF02719601.
5. Park S, Kim JH, Lee YC, Chung JB: Gastropericardial fistula as a complication in a refractory gastric ulcer after esophagogastrostomy with gastric pull-up. Yonsei Med J. 2010, 51: 270-2. 10.3349/ymj.2010.51.2.270.
Cited by
16 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献