Recurrent ulcer of the thoracic stomach penetrating the heart. Report of a case and review of the literature.

Recurrent and severe gastrointestinal bleeding caused the death of a 67-year-old man who had had resection of carcinoma of the cardiac end of the stomach. The hemorrhage was eventually found to be due to perforation of the wall of the left ventricle by a benign ulcer in the region of the esophagogastric anastomosis. At first, resection of the ulcer appeared to be successful, but recurrence of the penetrating ulcer caused fatal hemorrhage 4 1/2 months later. In our review of the literature, we found only one other instance in which an ulcer on an anastomosis perforated the heart. There were reports of 24 other cases of benign ulcers of the stomach or esophogus which penetrated the heart.