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Thorac Cardiovasc Surg 2005; 53(6): 365-367
DOI: 10.1055/s-2005-837705
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Gastropericardial Fistula and Candida kruzei Pericarditis Following Laparoscopic Nissen Fundoplication (Gastropericardial Fistula)

F. Farjah2 , C. B. Komanapalli1 , I. Shen1 , M. S. Sukumar1
  • 1Department of Surgery, Division of Cardiothoracic Surgery, Oregon Health and Science University, Portland, OR, USA
  • 2Department of Surgery, University of Washington, Seattle, WA, USA
Further Information

Publication History

Received November 22, 2004

Publication Date:
28 November 2005 (online)

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Abstract

We report a case of gastropericardial fistula and Candida kruzei pericarditis one year after laparoscopic Nissen fundoplication. Chest X-ray and CT revealed pneumopericardium. Barium swallow, UGI, endoscopy, and bronchoscopy were negative. Pericardial exploration was performed through a sternotomy. Intraoperative fistulogram revealed a tract into the stomach. A midline abdominal incision allowed identification of the slipped Nissen, resection of the fistula tract, and subsequent re-do fundoplication. The patient was treated with amphotericin and remains symptom-free 10 months after her operation. We recommend both sternotomy and midline abdominal incisions to explore and access the pericardium, stomach, esophagus, and diaphragm.

Key words

Fistula - infection - pericardium - complications of surgery

References

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M. Sukumar

OHSU Division of Cardiothoracic Surgery, Mailcode: L353

3181 SW Sam Jackson Park Road

Portland, Oregon 97239

USA

Phone: + 5034947820

Fax: + 50 34 94 78 29

Email: sukumarm@ohsu.edu