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

Document Type

Article

Publication Date

5-2026

Publication Title

Case Reports in Surgery

Abstract

Gastropericardial fistulas (GCs) are exceedingly rare in the reported literature. Etiologies include prior abdominal surgery, malignancy, and perforated gastric ulcers. Presenting symptoms range from chest pain to cardiac tamponade. Early imaging can help delineate the origin of the fistula. Management involves a multidisciplinary team, involving endoscopic stenting for temporization followed by definitive surgery for fistula closure. Robotic, video-assisted thoracoscopic surgery (VATS) with pericardial window has only been reported once in modern literature as definitive management for GCs. Thus, we present a case of a gastro-pericardial fistula that was temporized with endoscopic stenting and surgically managed with right robotic VATS with a pericardial window and definitive fistula closure. The patient had presented in cardiac tamponade with initial imaging demonstrating a large, loculated hydropneumopericardium and GC. The patient's postoperative course was unremarkable, and she was discharged on postoperative day 7. Follow-up within our health system is currently 4.5 years, and she continues to do well.

Volume

2026

First Page

5597348

Last Page

5597348

DOI

10.1155/cris/5597348

ISSN

2090-6900

PubMed ID

42146870

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