Esophageal Cancer with an Esophagopericardial Fistula and Purulent Pericarditis

Takayama, Tadateru; Okura, Yuji; Funakoshi, Kazuhiro; Sato, Tatsuhiko; Ohi, Hiroyuki; Kato, Toshiyuki

doi:10.2169/internalmedicine.52.8673

“…The treatment of pneumopericardium is also dependent on its presentation. Patients with hemodynamic instability require emergent pericardiocentesis 1,2,5,7 . Watchful waiting may be considered if asymptomatic and hemodynamically stable, as it happened to our patient and with Caselli et al 3 and Durães‐Campos et al, 6 as it can resolve spontaneously or by treatment of the underlying condition 8 …”

Section: Discussionmentioning

confidence: 76%

The “airgap” and “swirling bubbles” signs in a patient with esophageal carcinoma

Pinto

¹

,

Martins

²

,

Seabra

³

et al. 2023

Echocardiography

0

View full text Add to dashboard Cite

Introduction:Pneumopericardium is a dreaded complication in esophageal carcinoma. Case description:We report a case of a 62 year old patient with past history of esophageal cancer with pneumopericardium, without hemodynamic compromise.Admission echocardiogram that revealed a pneumopericadium with the presence of the "swirling bubbles" and the "air gap" sign. A small esophagopericardial fistula was postulated as the cause of the pneumopericardium. He underwent esophageal stent placement with almost complete resolution of the pneumopericardium.Discussion: Pneumopericardium is usually a sign of marked clinical deterioration in neoplasia and leads to patients' death few weeks. Here we presented a case, in which a more fortunate and unusual outcome happened. Case description:We present a case of a 62 year old patient, with a past history of esophageal cancer with pulmonary metastases undergoing palliative chemotherapy treatment and with two palliative esophageal stents. Other past medical history included active hepatitis B, arterial hypertension and dyslipidaemia. He was an ex smoker of 80 pack-year units.

show abstract

“…The treatment of pneumopericardium is also dependent on its presentation. Patients with hemodynamic instability require emergent pericardiocentesis [1,2,5,7]. Watchful waiting may be considered if asymptomatic and hemodynamically stable, as it happened to our patient and with Caselli et al [3] and Durães-Campos et al [6], as it can resolve spontaneously or by treatment of the underlying condition [8].…”

Section: Discussionmentioning

confidence: 80%

The “Airgap” and “Swirling Bubbles” signs in a Patient with Esophageal Carcinoma

Pinto

¹

,

Martins

²

,

Carvalho

³

et al. 2022

Preprint

0

View full text Add to dashboard Cite

Introduction: Pneumopericardium is a dreaded complication in esophageal carcinoma. Case description: We report a case of a 62 year old patient with past history of esophageal cancer with spontaneus pneumopericardium, without hemodynamic compromise. Admission echocardiogram that revealed a pneumopericadium with the presence of the “swirling bubbles” and the “air gap” sign. A small esophagopericardial fistula was postulated as the cause of the pneumopericardium. He underwent esophageal stent placement with resolution of the pneumopericardium. Discussion: Pneumopericardium is usually a sign of marked clinical deterioration in neoplasia and leads to patients’ death few weeks. Here we presented a case, in which a more fortunate and unusual outcome happened.

show abstract

“…Aside from pulmonary parenchymal disease, purulent pericarditis is associated with other infections of the mediastinum and neck, such as empyema, mediastinitis from dental infection, intracardiac medical devices, eroding intrathoracic malignancies, and endocarditis and bacteremia . The microbiology of purulent pericarditis reflects this, with Staphylococcus , Streptococcus , Haemophilus , and Mycobacterium tuberculosis predominating, though atypical organisms such as Candida and Salmonella have been described.…”

Section: Discussionmentioning

confidence: 99%