Gastro-pericardial fistula as an early complication after surgery for combined paraesophageal and hiatal hernia.

Open surgery is still used to treat massive combined paraesophageal and hiatal hernias. The operative principles include repositioning of the stomach in the abdomen, resection of the hernia sac, narrowing of the hiatus, and gastropexy. We report on a case in which a life-threatening, gastro-pericardial fistula was an early complication after open surgical treatment.