Purulent Pericarditis as the First Manifestation of Esophageal Carcinoma

Authors

  • Carolina María Peixoto Vieira Viseu Ferreira Department of Surgery and Medico-Surgical Specialities. University of Santiago de Compostela, Spain
  • Souhayla Souaf Division of Cardiac Surgery, University Hospital, Santiago de Compostela, Spain
  • Amparo Martínez Monzonís Division of Cardiology, University Hospital, Santiago de Compostela, Spain
  • Mohammad M. El-Diasty Cardiac Surgery Department. Harrington Heart and Vascular Institute. University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
  • Angel L. Fernandez Department of Surgery and Medico-Surgical Specialities. University of Santiago de Compostela, Spain; Division of Cardiac Surgery, University Hospital, Santiago de Compostela, Spain https://orcid.org/0000-0003-1307-8221

DOI:

https://doi.org/10.48729/pjctvs.423

Keywords:

purulent pericarditis, esophagopericardial fistula, esophageal carcinoma

Abstract

Introduction: Purulent pericarditis secondary to esophago-pericardial fistula is a serious complication that has been previously reported in patients with esophageal cancer treated with radio/chemotherapy and esophageal stenting. However, the presence of esophago-pericardial fistula as the first manifestation of advanced carcinoma of the esophagus is exceedingly infrequent. We report the case of a 61-year-old male who presented with sepsis, cardiac tamponade and septic shock who was found to have an esophago-pericardial fistula secondary to squamous carcinoma of the esophagus. Emergency pericardiocentesis was performed with subsequent hemodynamic improvement. The drained pericardial fluid was purulent in nature and cultures were positive for Streptococcus anginosus. A CT scan followed by upper gastrointestinal endoscopy with tissue biopsy confirmed the diagnosis of squamous cell carcinoma of the esophagus. A self-expanding covered stent was endoscopically placed to exclude the fistula and restore the esophageal lumen. In this report, we discuss some aspects related to the diagnosis and management of this serious clinical entity.

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References

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Published

13-05-2024

How to Cite

1.
Peixoto Vieira Viseu Ferreira CM, Souaf S, Martínez Monzonís A, El-Diasty MM, Fernandez AL. Purulent Pericarditis as the First Manifestation of Esophageal Carcinoma. Rev Port Cir Cardiotorac Vasc [Internet]. 2024 May 13 [cited 2024 May 21];31(1):59-62. Available from: https://pjctvs.com/index.php/journal/article/view/423

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Clinical Cases

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