Multidisciplinary management of a gastropericardial fistula using endoscopic stenting followed by right robotic VATS with a pericardial window resulted in successful definitive closure and survival at 4.5 years.
Case Report (n=1)
Demonstrates the successful multidisciplinary management of a rare gastropericardial fistula using endoscopic stenting and robotic VATS.
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.
Sypniewski et al. (Thu,) conducted a case report in Gastropericardial fistula (n=1). Endoscopic stenting and right robotic VATS with pericardial window and definitive fistula closure was evaluated on Clinical outcome. Multidisciplinary management of a gastropericardial fistula using endoscopic stenting followed by right robotic VATS with a pericardial window resulted in successful definitive closure and survival at 4.5 years.