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Archivos argentinos de pediatría

Print version ISSN 0325-0075On-line version ISSN 1668-3501


MAKAROVSKY, Jorge et al. Fístula ventriculogástrica: una causa excepcional de hemorragia digestiva alta. Corrección quirúrgica exitosa con circulación extracorpórea. Arch. argent. pediatr. [online]. 2004, vol.102, n.1, pp.49-52. ISSN 0325-0075.

The bleeding ventricular-gastric fistula is a pathology which can be exceptionally found in the daily practice, generally secondary to a benign peptic ulcer, and usually diagnosed at postmortem examination. Bibliography reports a mortality rate of almost 100% with conventional surgery. We report a 6-year-old patient with a medical history of esophageal repair after drinking caustic soda, and multiple mediastinal fistulae. The patient was examined because of high digestive bleeding with hypovolemic shock. A chest and abdominal helical computed tomography with contrast enhancement and multiplanar reconstruction was carried out, which revealed a fistula from the stomach to the heart. It was decided to perform surgical treatmen through sternal and abdominal approach with the use of cardiopulmonary bypass. A fistula between the left ventricle's posterior wall and the stomach was observed. Simple closing of the LV hole, partial gastrectomy, jejunostomy and gastrostomy were conducted. Conclusion. We believe that this case provides use fulguidelines for diagnosis and for a combined therapeutic approach by two surgical teams, as well as for the use of CPB, which can contribute to obtain better results than those published until today.

Keywords : Digestive hemorrhage; Ventricle-gastric fistula; Cardiopulmonary bypass.

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