Gastropericardial Fistula After Collis Gastroplasty and Nissen Fundoplication

Abnormal fistulization is a rare complication of Nissen fundoplication. A high index of suspicion and timely diagnosis are key factors to guide appropriate management. We describe a 70-year-old woman with a remote history of Collis gastroplasty and Nissen fundoplication presenting with chest pain and a pericardial effusion. She was transferred to our hospital after a pericardiocentesis drained gastric content. She underwent an emergent pericardial window for hemodynamic instability and a left thoracotomy to manage the fistula. We describe the successful management of her gastropericardial fistula and demonstrate that Collis gastroplasty is an additional risk factor for fistulization.