Esophagopericardial fistula: causes and radiographic features

Cyrlak, Dvora; Aj, Cohen; Dana, ER

doi:10.2214/ajr.141.1.177

Cited by 33 publications

(14 citation statements)

References 7 publications

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“…In 20% of these patients, pericardial effusion would not be demonstrated by contrast enhancement. 2 In the case reported here, chest computed tomography did not indicate the presence of a pericardial fistula. However, pericardiocentesis followed by a methylene blue test was a simple and useful method to confirm the presence of an esophagopericardial fistula, perhaps because methylene blue is more water soluble than contrast medium, and it is more practical as a bedside test in patients who have undergone pericardiocentesis for diagnosis or cardiac tamponade.…”

mentioning

confidence: 45%

Gastric Tube–Pericardial Fistula

2010

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confidence: 45%

Gastric Tube–Pericardial Fistula

2010

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“…A survey of the literature published in English found that 70 cases of esophagopericardial fistulas have been reported since 1931, 80% of which followed benign esophageal diseases (esophagitis, esophageal ulcers and injury due to ingestion of foreign bodies such as fish bones). Only 20% of the cases were caused by esophageal cancer (3)(4)(5)(6)(7). Given that esophagopericardial fistulas can cause purulent pericarditis and cardiac tamponade, their existence can be lifethreatening.…”

Section: Discussionmentioning

confidence: 99%

“…More than half of such fistulas involve the trachea or main bronchus, which increases the risk of pneumonia (2). Meanwhile, the development of esophagopericardial fistulas, a life-threatening complication, is rarely reported (3)(4)(5)(6)(7). The initial symptoms include epigastralgia, retrosternal pain and fever, which overlap with the symptoms of acute pericarditis (4-7).…”

Section: Introductionmentioning

confidence: 99%

Esophageal Cancer with an Esophagopericardial Fistula and Purulent Pericarditis

et al. 2013

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We herein present the case of a 56-year-old Japanese woman who developed purulent pericarditis after undergoing chemoradiotherapy for esophageal cancer. She developed epigastralgia and a fever and was admitted to our hospital. A physical examination revealed hypotension, tachycardia and pericardial friction rub. Echocardiography revealed moderate pericardial effusion. Based on these observations, the patient was diagnosed with cardiac tamponade. Computed tomography confirmed the presence of an esophagopericardial fistula. Treatment with pericardiocentesis, drainage and short-term intrapericardial administration of antibiotics relieved the patient's symptoms. Daily rinsing through a catheter with normal saline prevented relapse of the purulent pericarditis. Esophagopericardial fistulas are so rare that their treatment is not well-established. We herein report successful palliative care of a malignant esophagopericardial fistula associated with purulent pericarditis.

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“…Radiographic features of an esophago-pericardial fistula are a fluid level or air in the pericardial cavity and a cardiomegaly on a chest X-ray [25]. A fistula can be visualized by a contrast X-ray with water-soluble contrast.…”

Section: Discussionmentioning

confidence: 99%

“…A fistula can be visualized by a contrast X-ray with water-soluble contrast. Computed tomography will identify pneumopericardium, though the fistula itself may not be demonstrated [25]. Endoscopy can be used to visualize the fistula directly and to guide the extent of surgery.…”

Section: Discussionmentioning

confidence: 99%