Benign post-esophagectomy gastrocardiac fistula

Interact Cardiovasc Thorac Surg. 2011 Oct;13(4):447-9. doi: 10.1510/icvts.2011.276790. Epub 2011 Jul 25.


The development of a gastrocardiac fistula is a rare complication following retrosternal gastric conduit creation. We report a case of a 64-year-old male who presented three years after esophagectomy with massive hematemesis. A fistulous connection between his gastric conduit and right ventricle was identified and successfully treated. Although the patient had an atypical presentation and lacked most of the commonly cited risk factors, the combination of peptic ulcer disease and Candida overgrowth resulted in the formation of a gastrocardiac fistula. Adherence to treatment principles including prompt surgical intervention, adequate coverage of the repair, and antimicrobial therapy against Candida species provides the highest likelihood of success in addressing this potentially lethal disease process.

Publication types

  • Case Reports

MeSH terms

  • Candidiasis / complications
  • Esophageal Perforation / surgery
  • Esophagectomy / adverse effects*
  • Fatal Outcome
  • Fistula / diagnosis
  • Fistula / etiology*
  • Fistula / surgery
  • Gastric Fistula / diagnosis
  • Gastric Fistula / etiology*
  • Gastric Fistula / surgery
  • Gastrointestinal Hemorrhage / etiology
  • Heart Diseases / diagnosis
  • Heart Diseases / etiology*
  • Heart Diseases / surgery
  • Hematemesis / etiology
  • Humans
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use
  • Reoperation
  • Stomach Ulcer / complications
  • Stomach Ulcer / drug therapy
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Proton Pump Inhibitors