Open surgery is still used to treat massive combined paraesophageal and hiatal hernias. The operative principles include repositioning of the stomach in the abdomen, resection of the hernia sac, narrowing of the hiatus, and gastropexy [[6]]. We report on a case in which a life-threatening, gastropericardial fistula was an early complication after open surgical treatment.
Gastropericardial fistula - paraesophageal hernia - hiatal hernia - gastropexy