Thorac Cardiovasc Surg 2001; 49(5): 308-309
DOI: 10.1055/s-2001-17797
Case Report
© Georg Thieme Verlag Stuttgart · New York

Gastropleural Fistula Originating from the Lesser Curve:
a Recognised Complication,
an Uncommon Pathway of
Communication

I. Virlos1 , G.  Asimakopoulos2 , C.  Forrester-Wood1
  • 1Bristol Cardiothoracic Centre, Associate Directorate of Thoracic Surgery, Bristol Royal Infirmary, Bristol, United Kingdom
  • 2Cardiothoracic Department, Hammersmith Hospital, London, United Kingdom
Further Information

Publication History

Publication Date:
15 October 2001 (online)

Fistulous communications between the abdominal and the pleural cavity are rare; they implicate intra-abdominal sepsis. We present a rare case of subphrenic abscess following gastric perforation, which resulted in thoracic empyema. This report emphasises that gastropleural fistulas, although uncommon, should be considered in differential diagnoses of thoracic empyema, especially when there is a longstanding history of peptic ulceration.

References

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Received for Publication: March 19, 2001

Ioannis Virlos

Manchester Royal Infirmary
Department of GI Surgery
Oxford Road

M13 9WL, Manchester

UK

Phone: 0044-161-276 4244

Fax: 0044-161-276 4530

Email: itvirlos@hotmail.com

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