Gastropericardial fistula: radiologic findings and literature review

Acute tension pneumopericardium due to perforated gastric ulcer without diagnostic radiographic findings 72 h before perforation

“…Some reported cases of pneumopericardium are caused by bronchopericardial fistula formation due to bronchogenic carcinoma or pulmonary metastasis [4], but most described cases resulted from Sagittal computed tomography scan after pericardial perforation shows the compression of the right ventricle causing pericardial tamponade. gastropericardial fistulas [5]. A review of cases of pneumopericardium noted that nearly 80% of gastropericardial fistulas were secondary to prior surgery including fundoplication, esophagectomy, bariatric surgery, or partial gastrectomy [6,7].…”

Gastropericardial Fistula Presenting 27 Years after Bariatric Surgery

“…Gastropericardial fistula is an uncommon, late complication of gastric or esophageal surgery, including bariatric procedures, with an average of seven years separating surgery and presentation. 1 – 3 Less common causes include peptic ulcer disease and malignancy. 4 To our knowledge, this case represents the longest documented time period between surgery and diagnosis.…”

Fistula-Related Pericarditis as a Complication of Gastric Bypass Surgery

“…As bariatric surgery becomes more routine, rare complications such as enteropericardial fistula also become more likely and must be included in the differential diagnosis. Different etiologies include previous gastric or esophageal surgery, refractory gastric ulcers, trauma, tumour perforation, infection, presence of a foreign body, and caustic agent ingestion [2]. The most common presentation is a complication of prior surgery involving the stomach or the esophagus [2].…”

“…Different etiologies include previous gastric or esophageal surgery, refractory gastric ulcers, trauma, tumour perforation, infection, presence of a foreign body, and caustic agent ingestion [2]. The most common presentation is a complication of prior surgery involving the stomach or the esophagus [2]. It usually occurs within a hiatal hernia and rarely occurs transdiaphragmatically [1].…”

“…Cardiac ultrasound is the standard of care to study the pericardial sac followed by computed tomography as they both have high sensitivity. A cardiac tamponnade, however unlikely, requires emergent intervention and electrocardiogram findings are then also typical [2]. Surgical intervention is the classic treatment as patients rarely survive with conservative management [3].…”