Gastroesophageal cardiac fistula due to perforation of an esophagogastric anastomotic ulcer into the left atrium

Brynjolfsson, Gissur; Kania, R. J.; Bekeris, Leo

doi:10.1016/s0046-8177(80)80081-5

Cited by 21 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise, gastrointestinal hemorrhage is not the typical presentation of gastrocardiac fistulae. Most patients present with chest pain, sepsis, and purulent pericarditis [1][2][3][4][5][6]. Our patient had no evidence of pericardial effusion, pericardial emphysema, or intracardiac gas on CT-scan.…”

Section: Commentmentioning

confidence: 85%

“…C. albicans is commonly isolated from oral secretions and has been recovered as a dominant gastric inhabitant in patients on acid suppression therapy [8]. Various Candida species have been recovered from pericardial fluid and pathology specimens following operative treatment of gastrocardiac fistulae [2,3,6]. Chronic peptic ulceration and Candida superinfection have been described as risk factors for fistula formation [2].…”

Section: Case Reportmentioning

confidence: 99%

“…Although peptic ulcer disease and retrosternal conduits have been described as predisposing factors for gastrocardiac fistulae, this complication is commonest in the setting of malignancy, radiation, or ischemia [1][2][3][4][5][6][7]. Likewise, gastrointestinal hemorrhage is not the typical presentation of gastrocardiac fistulae.…”

Section: Commentmentioning

confidence: 99%

“…Such fistulae have been described in the setting of malignancy, chemoradiation therapy, or ischemia [1][2][3][4][5]. We report the unusual presentation and successful treatment of a patient with a benign gastrocardiac fistula in the setting of peptic ulcer disease and gastric Candida overgrowth.…”

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

Benign post-esophagectomy gastrocardiac fistula

Pentiak

Seder

Chmielewski

et al. 2011

Interactive CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

The development of a gastrocardiac fistula is a rare complication following retrosternal gastric conduit creation. We report a case of a 64-year-old male who presented three years after esophagectomy with massive hematemesis. A fistulous connection between his gastric conduit and right ventricle was identified and successfully treated. Although the patient had an atypical presentation and lacked most of the commonly cited risk factors, the combination of peptic ulcer disease and Candida overgrowth resulted in the formation of a gastrocardiac fistula. Adherence to treatment principles including prompt surgical intervention, adequate coverage of the repair, and antimicrobial therapy against Candida species provides the highest likelihood of success in addressing this potentially lethal disease process.

show abstract

Section: Commentmentioning

confidence: 85%

Section: Case Reportmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Benign post-esophagectomy gastrocardiac fistula

Pentiak

Seder

Chmielewski

et al. 2011

Interactive CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…Esophagoatrial fistula may be due to esophageal injuries such as perforation with feeding tubes, esophageal biopsies, esophageal surgery, erosion of an esophageal diverticulum into the left atrium, and carcinoma. [14][15][16][17][18][19][20][21] Rheumatic mitral valve disease with an enlarged left atrium and esophageal compression in association with the intake of potassium chloride tablets has been reported as a further cause of EAF. 22 Atrioesophageal fistula has been described as induced by trauma such as after a gunshot wound of the chest.…”

Section: Etiology Of Fistula Between Esophagus and Left Atriummentioning

confidence: 99%

Neurological Consequences of Atrioesophageal Fistula After Radiofrequency Ablation in Atrial Fibrillation

Stöllberger¹,

Pulgram²,

Finsterer³

2009

Arch Neurol

View full text Add to dashboard Cite

Background: Radiofrequency ablation for atrial fibrillation (RAF) is an increasingly performed procedure. It is performed during cardiac surgery or percutaneously by catheter. A dangerous complication of RAF is atrioesophageal fistula (AEF), which predominantly manifests neurologically owing to food embolism. Because neurologists may not be familiar with AEF and the prognosis is dependent on a prompt diagnosis, awareness of AEF by the neurologist may play a crucial role. Objective: To summarize for the neurologist the knowledge about fistula between the left atrium and esophagus occurring after RAF. Design, Setting, and Patients: Using a MEDLINE search, we collected reports about AEF after RAF in 28 patients. Main Outcome Measures: From the collected reports, the description of symptoms, diagnostic investigations, therapy, and outcome of the 28 patients were summarized. Results: In 28 cases, AEF developed 3 to 38 days after RAF. Confusion, grand mal seizures, meningitis, focal cortical signs, and postprandial transient ischemic attacks associated with fever were the leading manifestations in 21 of 28 patients. Blood tests showed leukocytosis, elevated serum C-reactive protein levels, and thrombocytopenia. Blood cultures were frequently positive for bacteria. Lumbar puncture revealed pleocytosis, elevated protein levels, increased lactate levels, and bacteria. Diagnosis was established by thoracic contrast computed tomography. Endoscopy, insertion of nasogastric tubes, and transesophageal echocardiography were detrimental, leading to an increase in fistula size and food or air embolism. Therapy comprised surgery (n=11) or temporary esophageal stenting (n = 1). The remaining patients died before attempted surgery or confirmation of the diagnosis. A neurological deficit persisted in 3 of the 9 surviving patients.

show abstract

A fatal Candida albicans pericarditis presenting with cardiac tamponade after COVID‐19 infection and cardiothoracic surgery

Salimi,

Davoodi,

Jalalian

et al. 2023

Clinical Laboratory Analysis

View full text Add to dashboard Cite

BackgroundCandida pericardial infection is a rare clinical entity usually related to recent cardiothoracic surgery and chronic debilitating conditions. During the COVID‐19 pandemic, invasive fungal infections have been on the rise, likely due to a combination of factors such as immunosuppression, underlying conditions like diabetes, and surgical procedures.Case PresentationHerein, we report a 67‐year‐old diabetic woman with a history of COVID‐19 infection who received a high dose of corticosteroids a few months before admission, and previous myocardial infarction for more than 12 years. The patient had a positive cardiac tamponade with signs of dyspnea, chest pain, and low blood pressure. Echocardiographic data were more in favor of constrictive pericarditis. The patient underwent urgent echocardiography‐guided pericardiocentesis and then broad‐spectrum antibiotic treatment was prescribed. Repeated echocardiography implied a persistent pericardial effusion 10 days later. Subxiphoid aspirates and biopsied tissues showed budding yeast cells and yeast colonies grew on culture media identified as Candida albicans.ConclusionThis report should bring to the attention of physicians toward the possibility of Candida pericardial infection presenting with cardiac tamponade after COVID‐19 infection and cardiothoracic surgery. Echocardiographic assessment, prompt pericardiotomy, molecular‐based identification of causative agent, and early administration of appropriate antifungal treatment should improve the patient's survival.

show abstract

Gastroesophageal cardiac fistula due to perforation of an esophagogastric anastomotic ulcer into the left atrium

Cited by 21 publications

References 4 publications

Benign post-esophagectomy gastrocardiac fistula

Benign post-esophagectomy gastrocardiac fistula

Neurological Consequences of Atrioesophageal Fistula After Radiofrequency Ablation in Atrial Fibrillation

A fatal Candida albicans pericarditis presenting with cardiac tamponade after COVID‐19 infection and cardiothoracic surgery

Contact Info

Product

Resources

About