CTICasesGastropericardial Fistula post Gastric Bypass
Imaging findings
Chest radiograph and CT show a massive, broad-band pneumopericardium and pericardial effusion. CT demonstrates a defect in the central tendon of the diaphragm and a fistulous tract connecting a gastric marginal ulcer post Roux-en-Y gastric bypass directly to the pericardial cavity.
Key takeaways
Gastropericardial fistula is a rare, life-threatening complication of gastric surgery or ulcers. Marginal ulcers at the gastric anastomosis can erode through the diaphragm and pericardium. Key radiographic features include a large pneumopericardium, which appears as a broad, clean air stripe outlining the heart.
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