Benign Gastric Ulcer Perforation into the Heart

A Rare Case Report

Abstract

Perforation of the heart is an extremely rare complication of benign peptic ulcer. To our knowledge, it has never been reported in Thailand. The case is reported here of a 46 years old man, who was admitted due to severe hematemesis and melena. The ulcerogenic agents in this patients include cigarettes, alcohol, tea, coffee and analgesic.

Later on the bleeding was still active, so an explore laparotomy was performed. A large benign gastric ulcer was found penetrating the diaphragm into the left ventricle. Unfortunately the patient died on the operating table.

This entity should be considered in patients with pneumopericardlum, anterior ulcers of the lower thoracic gastrointestinal tract, diaphragmatic ulcers in the intraabdominal gastric fundus and myocardial ischemia with upper gastrointestinal hemorrhage, especially if there is a history of esophagogastric surgery or hiatus hernia.