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The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 181-184, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Esophageal-atrial perforation due to recurrent esophagitis 18 years after esophageal bypass surgery

GF Murphy, AK Raymond and JG Scannell

A 62-year-old man presented with a grand mal seizure, progressive abdominal distention, and refractory hypotension 18 years after colonic bypass of a benign stricture of the low middle third of the esophagus. He died 3 hours after admission to the hospital. The patient had a history of liniment ingestion in childhood plus a long history of dysphagia and substernal pain. Autopsy disclosed a large ulcer of the anterior wall of the distal esophagus, which had eroded through the posterior wall of the left atrium. Histologic examination revealed chronic esophagitis with fibrous obliteration of the esophageal wall, pericardium, and left atrial myocardium near the site of perforation. Foreign material was present within small arteries of multiple viscera, and in several of these fragments transverse striations were demonstrated. Esophageal-atrial perforation is a rare but fatal complication of chronic esophageal ulceration. The clinical and pathological features of this and previously reported cases of nontraumatic esophageal-atrial perforation are reviewed.


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C. Stollberger, T. Pulgram, and J. Finsterer
Neurological Consequences of Atrioesophageal Fistula After Radiofrequency Ablation in Atrial Fibrillation
Arch Neurol, July 1, 2009; 66(7): 884 - 887.
[Abstract] [Full Text] [PDF]


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