Medicine · 2025
Successful treatment of gastropulmonary fistula in a patient with gastric diverticulum: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Yoon Tae-Hong, Lee Han Sol, Lee Chul Ho, Jeon Yun-Ho
Аннотация
RATIONALE: Gastropulmonary fistula (GPF) is defined as a communication pathway between the stomach and the lung. GPF is a rare condition, and there is no consensus regarding its treatment. GPF has been reported in only a small number of cases.
PATIENT CONCERNS: A 61-year-old male patient visited the emergency room due to abdominal pain and concurrent hematemesis that started 2 days prior. The patient reported a history of frequent vomiting attributed to chronic alcoholism and gastric ulcer-related bleeding. Multiple gastric ulceration and gastric diverticulum were diagnosed at that time.
DIAGNOSES: GPF was diagnosed by a noncontrast-enhanced chest computed tomography scan after swallowing an oral contrast agent.
INTERVENTIONS: GPF was treated with surgical intervention. A left lower lobectomy was performed through a posterolateral thoracotomy at the left 6th intercostal space. The 2.5 cm diaphragmatic opening was closed using a pledgeted 2-0 Prolene suture. In the abdomen, a partial gastrectomy was performed via an upper median laparotomy.
OUTCOMES: Successful surgical management of a PGF. Postoperative pneumonia developed on postoperative day (POD) 3, prompting a change in antibiotics. On POD20, an abdominal wound infection occurred, for which a vacuum-assisted closure system was applied. The patient began oral intake on POD33 and was discharged on POD56 after the removal of the tracheostomy tube.
LESSONS: This case demonstrates that surgical intervention should be considered the primary treatment option when managing a patient diagnosed with GPF.
PATIENT CONCERNS: A 61-year-old male patient visited the emergency room due to abdominal pain and concurrent hematemesis that started 2 days prior. The patient reported a history of frequent vomiting attributed to chronic alcoholism and gastric ulcer-related bleeding. Multiple gastric ulceration and gastric diverticulum were diagnosed at that time.
DIAGNOSES: GPF was diagnosed by a noncontrast-enhanced chest computed tomography scan after swallowing an oral contrast agent.
INTERVENTIONS: GPF was treated with surgical intervention. A left lower lobectomy was performed through a posterolateral thoracotomy at the left 6th intercostal space. The 2.5 cm diaphragmatic opening was closed using a pledgeted 2-0 Prolene suture. In the abdomen, a partial gastrectomy was performed via an upper median laparotomy.
OUTCOMES: Successful surgical management of a PGF. Postoperative pneumonia developed on postoperative day (POD) 3, prompting a change in antibiotics. On POD20, an abdominal wound infection occurred, for which a vacuum-assisted closure system was applied. The patient began oral intake on POD33 and was discharged on POD56 after the removal of the tracheostomy tube.
LESSONS: This case demonstrates that surgical intervention should be considered the primary treatment option when managing a patient diagnosed with GPF.