PMC7683165_01
(a) Dominant ulceration along the greater curvature. (b) Image within ulceration revealing fistula opening leading to pleural space marked by the asterisk.
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fig1
At the base of this ulcer appeared an external communication with a questionable fistula (Figure 1).
The arrow in (a) and (b) demonstrate a catheter passing from the stomach into the pleural cavity consistent with gastropleural fistula.
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fig2
Subsequent insertion of the gastric tube after endoscopy was completed, and follow-up CT imaging (Figure 2) showed right-sided gastric pull-through with a concerning fistulous tract connecting to the underlying lung parenchyma, as the distal tip of the gastric feeding tube terminated within a focal air lucency within the lung parenchyma.