Related Experiment Video

Updated: Dec 21, 2025

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
03:32

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment

Published on: December 27, 2024

1.4K

Coronary artery perforation into the upper gastrointestinal cavity due to gastric ulceration

Kenshi Yamanaga1, Kenji Sakamoto1, Ichiro Kajiwara2

  • 1The Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|May 20, 2020
PubMed

Insights

This case report details a rare instance of coronary artery perforation into the gastrointestinal tract during a procedure for inferior myocardial infarction. A covered stent successfully managed the perforation, achieving re-hemostasis.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Interventional Radiology

Background:

  • An 82-year-old male with a history of stomach cancer surgery presented with severe gastrointestinal bleeding and hypotension.
  • Initial evaluation revealed inferior myocardial infarction and active gastric ulceration.

Observation:

  • Upper endoscopy identified a bleeding gastric ulcer, which was treated with hemoclips.
  • Coronary angiography for an occluded right coronary artery (RCA) segment 4 atrioventricular (AV) led to coronary perforation during angioplasty.
  • Contrast material extravasation into the gastrointestinal cavity was observed during angiography.

Findings:

  • A covered stent was deployed in the RCA (segment 3 to 4 PD) to occlude the perforation site.
  • Successful re-hemostasis was achieved after stent placement.
  • This represents the first reported case of coronary artery perforation into the gastrointestinal tract.

Implications:

  • Highlights a rare but serious complication of percutaneous coronary intervention.
  • Demonstrates the successful management of coronary-gastrointestinal fistula using a covered stent.
  • Emphasizes the importance of multidisciplinary collaboration in managing complex cardiovascular and gastrointestinal emergencies.

Keywords:
coronary artery perforationgastric ulcerationgastrointestinal bleeding

More Related Videos

Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care05:50

Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care

Published on: September 22, 2023

4.0K
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors03:05

Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors

Published on: February 16, 2024

1.4K

Related Concept Videos

Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
318
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
355
Peptic Ulcer Disease I: Introduction01:30

Peptic Ulcer Disease I: Introduction

Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
659
Pathophysiology of Peptic Ulcer Disease: Injurious Factors01:22

Pathophysiology of Peptic Ulcer Disease: Injurious Factors

Peptic ulcers are sores on the stomach's inner lining and the upper small intestine, which are the result of disruptions in the mucosal layer that houses parietal cells which produce gastric acid, and chief cells which secrete pepsinogen.
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
971
Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
1.0K
Gastritis-II: Pathophysiology01:17

Gastritis-II: Pathophysiology

Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
1.0K