Gastropericardial fistula-a complication of hiatus hernia

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Abstract
A case is reported of a pneumopericardium in a 69-year-old woman caused by the rupture into the pericardium of a gastric ulcer situated in a hiatus hernia. Gastrografin studies were used to confirm the diagnosis and her initial conservative management was successful. However, she died at the operation to close her fistula, probably largely as a result of multiple unsuspected pulmonary emboli compounding her acid pericarditis.