1. Purulent Pericarditis as the First Manifestation of Esophageal Carcinoma.
- Author
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Peixoto Vieira Viseu Ferreira CM, Souaf S, Martínez Monzonís A, El-Diasty MM, and Fernandez AL
- Subjects
- Humans, Male, Middle Aged, Streptococcal Infections complications, Streptococcal Infections diagnosis, Streptococcus anginosus isolation & purification, Pericardiocentesis, Stents, Tomography, X-Ray Computed, Cardiac Tamponade etiology, Esophageal Neoplasms pathology, Esophageal Neoplasms complications, Pericarditis microbiology, Pericarditis etiology, Pericarditis therapy, Pericarditis diagnosis, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell complications, Carcinoma, Squamous Cell diagnosis, Esophageal Fistula etiology, Esophageal Fistula diagnosis
- 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.
- Published
- 2024
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