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Gastro-caval fistula after distal esophageal resection: a case report and review of the literature

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Abstract

Peptic ulceration with fistula formation into the inferior vena cava is rare, difficult to diagnose, and associated with high mortality. The nonspecific signs and symptoms make diagnosis challenging, delaying optimal treatment. Although there have been reports on duodeno-caval fistulas, gastric communication with the inferior vena cava is very rare. We report the second case of a fatal gastro-caval fistula and performed a review of the literature on entero-caval fistulas to emphasize the importance of early suspicion and to understand the most common presentation, as well as the best diagnostic and treatment modalities of this rare pathology.

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Abbreviations

ECF:

Entero-caval fistula

GCF:

Gastro-caval fistula

DCF:

Duodeno-caval fistula

JCF:

Jejuno-caval fistula

GIB:

Gastrointestinal bleeding

CT:

Computed tomography

EGD:

Esophagogastroduodenoscopy

PUD:

Peptic ulcer disease

IVC:

Inferior vena cava

PPI:

Proton-pump inhibitor

SIRS:

Systemic inflammatory response syndrome

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Author information

Authors and Affiliations

  1. Department of Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06032, USA

    Teresa Da Cunha & Sarah Rawi

  2. Department of Gastroenterology, Mayo Clinic, Rochester, MN, USA

    Daniela Guerrero Vinsard

  3. Department of Gastroenterology, University of Connecticut Health Center, Farmington, USA

    Osama Siddique

Authors
  1. Teresa Da Cunha
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  2. Daniela Guerrero Vinsard
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  3. Sarah Rawi
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  4. Osama Siddique
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Contributions

Drafting manuscript and development of figures (TDC), revising the manuscript with critical revisions (SR), (DGV), (OS).

Corresponding author

Correspondence to Teresa Da Cunha.

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The authors have no conflicts of interest related to this publication. There are no financial affiliations related to this publication.

Human Rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed Consent

We were not able to obtain informed consent from the patient as the patient was deceased. Upon trying to contact the family, the only available contact failed to answer after many attempts. There is no information in the report that enables the identification of the patient. Therefore, we kindly ask for a waiver in this case.

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Conference on October 25th, 2019 at the Connecticut Convention Center in Hartford, Connecticut. This case has not been published elsewhere, nor is it currently being considered for publication elsewhere.

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Da Cunha, T., Vinsard, D.G., Rawi, S. et al. Gastro-caval fistula after distal esophageal resection: a case report and review of the literature. Clin J Gastroenterol 14, 446–452 (2021). https://doi.org/10.1007/s12328-020-01324-z

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  • DOI: https://doi.org/10.1007/s12328-020-01324-z

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