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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Open-heart surgery was performed on 1686 adult patients between 1980 and 1984, with a mortality rate due to abdominal complications of 0.6%. Every operation involved the use of cardiopulmonary bypass (CPB). Abdominal complications occurred in 1.6%, with an overall mortality rate of 36%. The most frequent complication was gastrointestinal (Gl) bleeding (61%). The mortality of the patients who bled from the Gl tract was 53%. Other complications encountered were gastroduodenal ulcer, colitis, ileus, subphrenic abscess and intraperitoneal bleeding. Prolonged CPB and low output syndrome preceded multiple organ failure, which occurred in 39% of those who had abdominal complications and in 59% of those who bled. Gl bleeding after CPB did not correlate with a previous history of gastric ulcer. Reoperation because of cardiac tamponade or excessive chest tube drainage was a factor predisposing to Gl bleeding. The mortality and abdominal complication rates were significantly higher in valve surgery than in coronary revascularization.
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PMID:Abdominal complications following cardiopulmonary bypass in open-heart surgery. 349 77

A case of acute cardiac tamponade due to perforation of a benign gastric ulcer into the pericardium is presented. A high index of suspicion, early diagnosis and prompt surgical intervention resulted in a favourable outcome in this otherwise uniformly fatal condition.
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PMID:Gastropericardial fistula presenting as acute cardiac tamponade. A case report. 669 50

Pyopneumopericardium caused by transdiaphragmatic perforation of gastric ulcer is very rare. A 60-year-old man was admitted to our hospital because of chest pain with high fever. The chest computed tomography (CT) revealed hydropneumopericardium. The patient was diagnosed as purulent pericarditis. So emergent pericardiectomy and pericardial drainage were performed to relieve cardiac tamponade. Two findings enabled us to diagnose the causation of pyopneumopericardium as gastropericardial fistura. The first finding was that endoscopic examination of upper gastrointestinal tract revealed a deep peptic ulcer in the dome of gastric fundus. The second finding was that a dye solution which was injected into the pericardial cavity via the drainage tube leaked out into the gastric cavity through the ulcer. This patient improved successfully by the treatment of intravenous hyperalimentation including antibiotics and omeprazole. We think that expedient diagnosis and surgical drainage are essential for successful patient outcome.
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PMID:[Pyopneumopericardium caused by perforation of gastric ulcer; report of a case]. 1588 Dec 44

Esophagopericardial fistula is a rare and severe complication, involving several benign, malignant and traumatic pathologies of the esophagus. Only few cases of esophagopericardial fistula have been published so far, as compared to more frequently reported cases of gastropericardial fistula. We report on a 25-year-old female with an esophagopericardial fistula following retrosternal esophagogastroplasty for esophageal caustic stenosis. One month before admission to our hospital, the patient had fever and nonradiating substernal chest pain which was relieved by aspirin, unfortunately without adequate antacid therapy. After 3 weeks, for abdominal pain and worsening chest pain with shock, she was admitted to another hospital and underwent laparotomy: an haemoperitoneum was found, due to a rupture of an ovarian cyst which was removed. For persistent shock, the patient had an echocardiogram which revealed a cardiac tamponade, treated with placement of a pericardic drainage (300 cc of purulent liquid). She was then transferred to our unit: an esophageal swallow with a small amount of methilene blue revealed a fistula between the stomach of the esophagogatroplasty and the pericardium. She eventually underwent surgery. A pericardial window was created, the gastric tube was taken down because of the impossibility to suture the gastric ulcer, and an esophagocoloplasty was used for the reconstruction of the alimentary transit. The postoperative course was unevenqf&l. She is alive and well at 15 months after surgery. Esophagopericardial fistula is a rare complication, with a high mortality rate. A timely decision is mandatory and an aggressive treatment often necessary.
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PMID:[Treatment of esophagopericardial fistula following esophagogastroplasty for esophageal caustic stenosis]. 1772 1

Pneumopericardium is a rare but serious cause of morbidity and mortality. Untreated, it can lead to cardiac tamponade and thus must be promptly identified to treat the underlying etiology. Here, we report a case of spontaneous pneumopericardium secondary to gastric ulcer perforation in association with a hiatal hernia. The diagnosis of pneumopericardium was first made under fluoroscopy during cardiac catheterization and a follow-up CT of the chest revealed a gastropericardial fistula as the initiating event. The patient underwent emergent thoracotomy and partial esophagogastrectomy which eventually resulted in a full recovery and discharge on postoperative day 19. Our unique experience with this rare and often fatal disease suggests that early diagnosis combined with an early and aggressive surgical strategy is critical for minimizing morbidity and mortality.
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PMID:Pneumopericardial tamponade resulting from a spontaneous gastropericardial fistula. 1919 63