Gastric tube perforation penetrating the pericardium after esophagectomy that needed surgical repair

Abstract

BackgroundAs the prognosis of esophageal cancer surgery has improved, reports on postoperative complications of gastric tubes have increased. Among them, gastric tube ulcer perforation is infrequent but often severe and difficult to treat.Case PresentationA 73‐year‐old man had undergone thoracoscopic subtotal esophagectomy and laparoscopic‐assisted gastric tube reconstruction via the retrosternal route for thoracic esophageal cancer 8 years previously. He was transferred to our hospital with a diagnosis of gastric tube ulcer perforation, penetrating the pericardium. Emergency surgery was performed to remove the gastric tube, followed by immediate reconstruction by right colon interposition. The patient was discharged on postoperative day 142.ConclusionWe report a rare complication of gastric tube ulcer perforation, penetrating the pericardium, after esophagectomy for esophageal cancer. It was successfully treated with appropriate surgical management.

Hydropneumopericardium Due to a Traumatic Esophageal-Pericardial Fistula

“…Management varies depending on the severity of presentation, with surgical intervention recommended for cases of EPF associated with extensive mediastinal and pericardial food-material contamination, ongoing bleeding or hematoma accumulation, or abscess formation. 7 However, there is a growing trend toward using a combination of endoscopic stenting and pericardial drainage, particularly when cases are diagnosed early and the patient is stable. When cardiac tamponade complicates the picture, urgent pericardial decompression, either surgical or percutaneous, is necessary.…”