Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous pneumopericardium is a relatively rare event, although cases have been recorded over the past 130 years. Many were associated with malignancy, trauma, infection or as a complication of recent surgery. Attempts at surgical resolution have been infrequent and survival extremely rare. We describe a patient in whom pneumopericardium developed spontaneously and insidiously, probably being present for some weeks before hospital investigation. Surgical exploration revealed the cause to be a benign gastric ulcer without an hiatus hernia or other diaphragmatic defect. Repair was attempted but the patient died in the early postoperative period. From an extensive review of the literature it is clear that spontaneous perforation of a gastric ulcer into the pericardium must be less rare than some authors have suggested.
 ...
PMID:Spontaneous pneumopericardium. 96 5

Elderly patients often have unusual manifestations of common illnesses. We describe a geriatric patient having a pneumopericardium from pericardial penetration by a gastric ulcer. Benign gastric ulceration causing perforation of the pericardium or other cardiac structures was recognized as early as 1854; however, until 1964, the condition was invariably fatal. Our patient survived the episode after early pericardiocentesis and medical treatment. Aspects of this uncommon clinical entity and a brief review of the literature are described.
 ...
PMID:Penetration of the pericardium by a gastric ulcer--survival after pericardiocentesis. 224 96

A 49-year-old obese female was admitted for acute onset pleuritic chest pain. Previous history was significant for surgical correction of a lower esophageal ring. Echocardiography revealed a pericardial effusion, which resolved with steroids. One week later, the patient complained of similar symptoms. Physical examination was consistent with tamponade, while a Hammond crunch was noted over the sternum. Chest x-ray revealed a pneumopericardium. Operative findings consisted of an intrathoracic stomach, a greater curvature ulcer that had perforated the pericardium and a mediastinal abscess. A pericardial window was created, a drain was placed and the perforated ulcer was repaired. Postoperative course was complicated by fever and gastrointestinal bleeding. The patient died suddenly on the 30th postoperative day. Autopsy revealed a massive pulmonary embolus, bleeding esophageal ulcer, healed gastric ulcer and serofibrinous pericarditis. This case illustrates that, while the immediate treatment of tension pyopneumopericardium is usually successful, postoperative mortality remains elevated.
 ...
PMID:Benign pneumopericardium and tamponade. 788 42

An 81-year-old woman without any known previous disease was admitted for epigastralgia, nausea, vomiting and anorexia since 15 days. The investigations disclosed a pneumopericardium which was caused by the perforation of a gastric ulcer, situated on the collar of an hiatal hernia. A pericardial drainage and a suture of the ulcer were performed, but the patient could not be saved. Despite an optimal treatment composed of pericardial drainage, specific surgery and intensive care, the mortality rate of pneumopericardium is still around 50% proving the severity of this illness.
 ...
PMID:[Pneumopericardium: a race against time! Case report and literature review]. 876 87

A 88-year-old male patient presented with fever, singultus and retrosternal pain. After 8 days of antibiotic therapy not resulting in clinical improvement, he suddenly developed a pneumopericardium. Contrast swallow and endoscopy showed intrapericardial perforation of a benign gastric ulcer. Excision of the ulcer and suturing of both the stomach and the diaphragm as well as lavage of the pericardium were done over a left thoracotomy. The patient recovered uneventfully.
 ...
PMID:Pneumopericardium due to intrapericardial perforation of a gastric ulcer. 1249 25

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.
 ...
PMID:Pneumopericardial tamponade resulting from a spontaneous gastropericardial fistula. 1919 63

A 53-year-old homeless male presented to the emergency department with sudden onset chest pain and was found to have a large pneumopericardium on chest X-ray. The patient had no history of surgery, hiatal hernia, or ulcer disease. A contrast-enhanced computed tomography scan demonstrated the pneumopericardium and raised concern for possible gastropericardial fistula from a benign gastric ulcer. An esophagogastroduodenoscopy confirmed the fistula, as did surgery, and intraoperatively vegetable particular matter was removed from the anatomic space continuous with the pericardium.
...
PMID:Case report: benign gastric ulcer erosion leading to a gastropericardial fistula in a patient with no known risk factors. 2462 91

Spontaneous pneumomediastinum is defined as free air or gas contained within the mediastinum, which almost invariably originates from the alveolar space or the conducting airways. It is rare in pediatric patients; however, occasional cases are reported to result from forced Valsalva's maneuver due to cough, emesis, a first attack of wheeze, or asthma exacerbations. We report the case of a 7-year-old previously healthy girl, with a history of persistent dry cough one day before, who was brought to our unit with face, neck and chest swelling. The chest X-ray and computed tomography (CT) scan showed subcutaneous emphysema with pneumomediastinum and pneumopericardium without evidence of the origin of this air leak. Laboratory tests and the bronchoscopy were normal. The patient was admitted in the pediatric critical care and received noninvasive monitoring, analgesia, oxygen, and omeprazole as a prophylaxis for a gastric ulcer. The patient improved, subcutaneous emphysema resolved, and she was discharged on the third day.
 ...
PMID:A Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema in Children. 2941 95