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      Radiologic evaluation of postoperative gastropericardial fistula

      a , * , b , c

      Radiology Case Reports

      Elsevier

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          Abstract

          Laparoscopic Nissen fundoplication is the current standard surgical option for complicated GERD and symptomatic hiatal hernia. Though comparable in safety, short-term efficacy, and patient satisfaction when compared with open operation, laparoscopic Nissen fundoplication has demonstrated shorter hospital stays and recuperative times. Commonly reported complications include gastric or esophageal injury, splenic injury, pneumothorax, bleeding, pneumonia, fever, wound infections, and dysphagia. We present an unusual case of gastropericardial fistula that developed as a late complication of laparoscopic Nissen fundoplication performed 4 years earlier.

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          Most cited references 12

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          Gastropericardial fistula: a case report and review of literature.

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            Gastropericardial fistula after laparoscopic surgery for reflux disease.

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              Expression patterns of transforming growth factor-beta and its receptors in gastric mucosa of patients with refractory gastric ulcer.

              Transforming growth factor-beta (TGF-beta) plays a regulatory role in tissue repair. In a previous study, we found that TGF-beta and its receptors were expressed in gastric mucosa of patients with well-healed gastric ulcers, as demonstrated by immunohistochemistry. To further characterize the role of TGF-beta and its receptors in repairing gastric ulcers, we investigated the expression patterns of TGF-beta and its receptors in gastric mucosa by in situ hybridization and reverse transcriptase-polymerase chain reaction (RT-PCR). Seventy-four patients with endoscopically proven gastric ulcers were eligible for participation in this study. All patients had routine biopsies on initial endoscopy and were then treated for 12 wk with an H2 blocker. Repeat endoscopy was then performed. There were 8 patients with poorly healed ulcers, and biopsies were taken from the margin of the residual ulcers. These tissue samples, along with biopsy of gastric mucosa near the original ulcers from 8 randomly selected patients with well-healed ulcers were examined for TGF-beta and TGF-beta receptor II mRNA by RT-PCR and in situ hybridization, as well as immunohistochemistry. TGF-beta and TGF-beta receptor II were strongly expressed in tissues from patients with well-healed ulcers. Four of the 8 patients with poor healing had low or absent expression of TGF-beta or TGF-beta receptor II mRNA. All cases positive by RT-PCR assay were confirmed by in situ hybridization as well as immunohistochemistry. It is suggested that TGF-beta and its receptors are important for gastric ulcer healing. These results may have implications for further investigation of the healing process and in predicting response to therapy.
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                Author and article information

                Contributors
                Journal
                Radiol Case Rep
                Radiol Case Rep
                Radiology Case Reports
                Elsevier
                1930-0433
                06 November 2015
                2014
                06 November 2015
                : 9
                : 3
                Author notes
                [* ]Contact Mr. ChenContact Mr. Chen jchen2@ 123456hmc.psu.edu
                [a]

                Mr. Chen is a medical student at Pennsylvania State University College of Medicine, Hershey PA.

                [b]

                Dr. Hal is in the Department of Radiology at the Penn State Hershey Medical Center, Hershey PA.

                [c]

                Dr. Tappouni is in the Department of Radiology at Wake Forest University School of Medicine, Winston-Salem NC.

                Article
                S1930-0433(15)30085-6 952
                10.2484/rcr.v9i3.952
                4861863
                27186253
                © 2014 The Authors.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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