Korean J Gastrointest Endosc > Volume 29(1); 2004 > Article
Korean Journal of Gastrointestinal Endoscopy 2004;29(1): 13-16.
식도암으로 식도 절제술 및 위 식도문합술 후 합병증으로 발생한 위심막루
손동균·김재광·정지성·조돈현·김형근·박수헌·한준열·정규원·선희식
가톨릭대학교 의과대학 내과학교실
A Case of Gastropericardial Fistula as a Complication after Esophagectomy with Esophagogastrostomy for Esophageal Cancer
Dong Kyun Son, M.D., Jae Kwang Kim, M.D., Ji Sung Chung, M.D., Don Hyoun Jo, M.D., Hyung Keun Kim, M.D., Soo-Heon Park, M.D., Joon-Yeol Han, M.D., Kyu Won Chung, M.D. and Hee Sik Sun, M.D.
Devision of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Abstract
The gastric pedicle is commonly used for the reconstruction following the resection of esophageal cancer. We recently experienced a case in which gastric ulcer occurred eighteen months postoperatively. A 60 year-old man complaining of chest pain, dry cough, mild fever and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy because of esophageal cancer. Chest X-ray and CT scan showed pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach pedicle and the pericardium. Upper GI endoscopy showed beating heart through the fistulous opening. The patient expired with sepsis on the twenty second days after an emergent operation. Gastropericardial fistula caused by a peptic ulcer perforation after the esophgectomy and esophagogastrostomy operation is a very rare complication and brings a fatal result. Early detection using the chest radiography, electrocardiogram, echocardiography, upper GI study and physical examination, and an immediate treatment are therefore mandatory. (Korean J Gastrointest Endosc 2004;29:13⁣16)
Key Words: Gastropericardial fistula, Esophageal cancer operation
주요어: 식도암, 위 식도문합술, 위심막루
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