Abstract
We report a case of refractory gastric tube ulcer perforating the right atrium. A 72-year-old man with a history of esophageal cancer and subtotal esophagectomy with posterior mediastinal gastric tube reconstruction was diagnosed with a gastric tube ulcer 6 months previously. He developed fever and hemoptysis, was admitted to our department for the treatment of pneumonia, and was then followed-up with antibiotic therapy. However, there was sudden onset of septic shock and bleeding from the gastric tube, and he was transferred to the ICU. The administration of blood transfusion and a vasopressor was not effective, and the patient died of hemorrhagic shock on the fifth day after ICU admission. Autopsy revealed gastric tube ulcer perforation of the right atrium. Gastric tube ulcer perforation has been recognized a fatal postoperative complication. Some patients with such a complication remain asymptomatic until their condition worsens or changes suddenly. To improve the prognosis of patients with gastric tube ulcer through early diagnosis and treatment, it is important to pay attention to symptoms other than gastrointestinal ones.
