Case report of A 72-year-old Man with Diaphragmatic Hernias and Thoracic Gastropericardial Fistula after Esophagectomy for 18 Years

Abstract Background: Both diaphragmatic hernias and thoracic gastropericardial fistula rarely occurred simultaneously on patients with radical esophagectomy.Case presentation: A 72-year-old man presented to our hospital with one day of nausea, vomiting and acute left chest pain. He had radical esophagectomy for esophageal cancer 18 years ago. Computed tomography (CT) of the chest revealed diaphragmatic hernias and air collection within pericardial space. While an operation of diaphragmatic hernia repair was decisively performed to prevent further serious complications, the thoracic gastropericardial fistula was also found unusually. Conclusion: Diaphragmatic hernias and thoracic gastropericardial fistula may occasionally coexist in patients with esophagectomy. Upper GI radiograph with water-soluble contrast agent is a better diagnosis tool than CT in visualizing the fistula.