A 41-year-old male smoker presented with choking and coughing up food associated with repeated vomiting. Four years previously, following recurrent episodes of pancreatitis, he required percutaneous necrosectomy. He subsequently had a cholecystectomy and mesh repair of the abdominal wall, and later developed multiple problems including a gastrobronchial fistula. Computed tomography revealed a fistulous connection for which he had a combined procedure. Through a thoracolaparotomy approach, the left lower lobe and fistulous connection were removed along with the surrounding diaphragm and the associated fundus of the stomach. The diaphragm defect was repaired without mesh.
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