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Penetration of a gastric ulcer into the right ventricle. A complication of para-oesophageal hiatus hernia.

A 74-year-old woman presented with massive upper gastro-intestinal tract bleeding that necessitated an emergency laparotomy. At operation a para-oesophageal hiatal hernia with an ulcer in the herniated fundus of the stomach penetrating the right ventricle was discovered to be the source of the bleeding. Although various complications of para-oesophageal hiatal hernias have been reported, including bleeding, this is the first reported case of ulcer penetration into the ventricle.