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Recurrent Gastropericardial Fistula: A Case Report

Steven Pong1, Herbert Downton Ramos2, Justin Van Backer3

  • 1Department of Surgery, Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, USA.

Cureus
|May 19, 2025
PubMed

Insights

Gastropericardial fistula (GPF) is a rare complication after upper GI surgery. This case highlights recurrent GPF management, emphasizing early diagnosis and aggressive surgical intervention for better patient outcomes.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Surgical Oncology

Background:

  • Gastropericardial fistula (GPF) is a rare but severe complication following upper gastrointestinal surgery.
  • Recurrent cases are exceptionally uncommon, posing significant diagnostic and therapeutic challenges.

Observation:

  • A 77-year-old male with extensive surgical history presented with nonspecific symptoms including chest pain, vomiting, and sepsis.
  • Diagnostic imaging (CT) and esophagogastroduodenoscopy confirmed recurrent gastropericardial fistula.

Findings:

  • The patient underwent multiple surgical procedures: pericardial window creation, GPF takedown, and omental flap placement.
  • Successful management of recurrent GPF required a multi-step, aggressive surgical approach.

Implications:

  • This case underscores the critical need for high clinical suspicion in patients with relevant surgical history presenting with vague symptoms.
  • Prompt diagnosis and aggressive, multi-modal surgical management are crucial for improving outcomes in recurrent gastropericardial fistula.
  • Diligent postoperative care is essential for managing this rare and complex surgical complication.
Keywords:
gastropericardial fistulagastropleural fistulaintrathoracic gastric fistulapneumopericardiumupper gastrointestinal surgery

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