ASGE DDW Videos from Around the World | 2026-ENDOSCOPIC CLOSURE OF GASTROPERICARDIAL FISTULA WITH ACTIVE PERICARDIAL DECOMPRESSION TO PREVENT TAMPONADE

ENDOSCOPIC CLOSURE OF GASTROPERICARDIAL FISTULA WITH ACTIVE PERICARDIAL DECOMPRESSION TO PREVENT TAMPONADE

Video Transcription

Video Summary

An 84-year-old woman developed a rare gastropericardial fistula after prior chest radiation, likely from a gastric ulcer/hiatal hernia complication. She presented in shock with severe anemia, pneumopericardium, and suspected tamponade. Because she was too unstable for surgery, a multidisciplinary team placed a pericardial drain before endoscopy. During CO2 insufflation, tamponade occurred but was relieved by opening the drain. The fistula was then closed endoscopically with OverStitch suturing, and success was confirmed with a water-seal test. The case highlights pericardial decompression as a critical safeguard during endoscopic repair.

Asset Subtitle

Endoscopy in Action
Submitted by Shuji Mitsuhashi

Meta Tag

Concept Gastropericardial Fistula

Concept Pneumopericardium

Concept Tamponade

Concept Hiatal Hernia

Concept Gastric Perforation

Keywords

gastropericardial fistula

pericardial drain

endoscopic OverStitch repair

pneumopericardium

tamponade

Gastropericardial Fistula

Pneumopericardium

Tamponade

Hiatal Hernia

Gastric Perforation