Related Experiment Video

Updated: May 19, 2026

Technical Considerations and Approach to Redo Foregut Surgery
04:14

Technical Considerations and Approach to Redo Foregut Surgery

Published on: September 22, 2023

Heartburn Takes a Whole New Meaning: Multidisciplinary Management of a Gastropericardial Fistula

Jake Sypniewski1, Jesse K Kelley2, G Dane Fritz3

  • 1College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA, msu.edu.

Case Reports in Surgery
|May 18, 2026
PubMed

Insights

Gastropericardial fistulas are rare but serious conditions. This case study highlights successful management using endoscopic stenting and robotic surgery for a patient presenting with cardiac tamponade.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Thoracic Surgery

Background:

  • Gastropericardial fistulas (GCs) are rare, with causes including surgery, malignancy, and ulcers.
  • Symptoms vary from chest pain to cardiac tamponade, requiring prompt diagnosis.

Purpose of the Study:

  • To present a case of gastropericardial fistula managed with endoscopic stenting and robotic surgery.
  • To highlight the successful outcome of this combined approach.

Main Methods:

  • Diagnosis confirmed by imaging showing hydropneumopericardium and fistula.
  • Initial management involved endoscopic stenting for temporization.
  • Definitive treatment utilized robotic video-assisted thoracoscopic surgery (VATS) with a pericardial window for fistula closure.

Main Results:

  • The patient presented with cardiac tamponade and a gastropericardial fistula.
  • Endoscopic stenting successfully temporized the condition.
  • Robotic VATS with pericardial window achieved definitive fistula closure.
  • The patient experienced an uncomplicated recovery and was discharged on postoperative day 7.
  • Long-term follow-up of 4.5 years shows continued well-being.

Conclusions:

  • Robotic VATS with a pericardial window is a viable surgical option for gastropericardial fistulas.
  • A multidisciplinary approach combining endoscopic stenting and robotic surgery offers effective management for GCs.
  • This case demonstrates a successful long-term outcome for a rare gastropericardial fistula.

Keywords:
endoscopic stentinggastropericardial fistulapericardial windowvideo-assisted thoracoscopic surgery (VATS)

Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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:
Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Peptic Ulcer Disease IV: Management01:26

Peptic Ulcer Disease IV: Management

Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
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...
Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease