Liver penetration and gastrobronchial fistula : unusual complication of a peptic ulcer

The authors present the first case report on a patient with liver penetration and a gastrobronchial fistula from a gastric ulcer. Liver penetration was diagnosed by endoscopy, and the gastrobronchial fistula was noted on a computed tomography scan. An emergent total gastrectomy was performed because of uncontrolled massive gastric bleeding not responsive to conventional treatment. The initial treatment of choice for these patients should be conservative because both complications could potentially have been controlled by H 2 blockers and percutaneous drainage of the abscess.