1985
DOI: 10.1055/s-2007-1014163 View full text |Buy / Rent full text
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Abstract: A case of esophago-pericardial fistula is described which was treated successfully by pericardial drainage and closure of the fistula 12 days after perforation. The condition is rare and often fatal. In 29 reported cases there were only 5 survivors. On the basis of our observation and a review of the literature it is concluded that the first step in the treatment should be pericardial drainage and antibiotic coverage, followed by elective operative closure of the fistula.

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“…Esophageal ulcer will penetrate any organ in the mediastinum close to the esophagus [8], and even in cases of contained perforations, the high frequency of concomitant diseases such as alcoholism, mental deficiency, and schizophrenia prolong diagnosis, thereby making mediastinitis more severe. In the perforations of vital organs in the mediastinum, mortality is high, 83% of 29 patients in a review of esophagopericardial fistula [11]. In our study, one quarter of fatalities was found dead at home with only a quarter diagnosed before death.…”
Section: Discussionmentioning
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“…Esophageal ulcer will penetrate any organ in the mediastinum close to the esophagus [8], and even in cases of contained perforations, the high frequency of concomitant diseases such as alcoholism, mental deficiency, and schizophrenia prolong diagnosis, thereby making mediastinitis more severe. In the perforations of vital organs in the mediastinum, mortality is high, 83% of 29 patients in a review of esophagopericardial fistula [11]. In our study, one quarter of fatalities was found dead at home with only a quarter diagnosed before death.…”
Section: Discussionmentioning
“…Perforations or fistulas may occur in all mediastinal structures [4,7,8,9,10]. Though esophageal ulcer is considered to cause death only rarely [1], its complications such as esophagopericardial fistula carry a high mortality rate [11]. The true mortality and true prevalence of these life-threatening complications at the population level is, however, unknown because reports dealing with these complications are based on case series or on small clinical data from a single unit.…”
Section: Introductionmentioning
“…Esophagopericardial fistula (EPF) is a rare medical entity with fewer than 70 cases documented in the literature since 1972 [8,9]. In the pediatric population, we found 3 documented cases including the one described above.…”
Section: Discussionmentioning
“…In the pediatric population, we found 3 documented cases including the one described above. The others occurred in the setting of duodenal stenosis with accompanying peptic ulcer [8] and after foreign body ingestion [10].…”
Section: Discussionmentioning
“…The etiology of purulent pericarditis includes Streptococcus pneumoniae (33%), Staphylococcus (23%), aerobic Gram-negative rods (19%), other streptococci (11%), and Neisseria meningitidis (4%), as well as, very rarely, anaerobes rodes and Hemophilus influenzae (2). Purulent pericarditis also can be associated with esophago-pericardial fistula secondary to invasive esophageal cancer (3,4). An esophago-pericardial fistula should be strongly suspected on the basis of clinical signs, even in the absence of other evidence from complementary investigations.…”
Section: Discussionmentioning