Perforation of a Gastrojejunal Ulcer Into the Pericardium: Complication of Wermer's Disease (Zollinger-Ellison Syndrome)

SINCE Zollinger and Ellison first described the syndrome bearing their name1 and consisting of unrelenting peptic ulceration, gastric hyperacidity, and pancreatic islet-cell adenoma or carcinoma, many additional aspects of this disorder have been described.2 The syndrome of endocrine adenomatosis (Wermer's disease)3 was described in only eight of the 260 patients reviewed by Ellison.2We have recently treated a patient with Wermer's disease (Zollinger-Ellison syndrome) and gastrojejunopericardial fistula in whom the preoperative diagnosis was made and surgical correction attempted. Communication between the pericardial cavity and the gastrointestinal tract is an extremely rare but serious complication of peptic ulceration which is of much interest to clinicians. The report of a single case is prompted by the rarity of this condition as well as its interesting diagnostic and therapeutic aspects. REPORT OF CASE A 62-year-old Negro man was admitted to the Queens Hospital Center for the third time on