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CASE REPORT
Cardiac tamponade and purulent pericarditis secondary to an oesophageal pericardial fistula as an initial presentation of squamous cell carcinoma of the oesophagus
  1. Hafez Mohammad Ammar Abdullah1,
  2. Uzma Ikhtiar Khan2,
  3. Chetan Wasekar1 and
  4. Muhammad Omar1
  1. 1 Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
  2. 2 Internal Medicine, Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan
  1. Correspondence to Dr Hafez Mohammad Ammar Abdullah, ammar.abdullah{at}usd.edu

Abstract

Pericardial effusions resulting in a cardiac tamponade have previously been reported with oesophageal cancers. However, most of these cases have been reported in association with radiation and chemotherapy. Rarely as oesophageal pericardial fistuls (OPF) have been reported as the culprits in causing pericardial effusions in patients with oesophageal cancers. Here we present the case of a 61-year-old woman who presented clinically with cardiac tamponade. She was found to have an OPF due to oesophageal squamous cell cancer that resulted in a purulent pericardial effusion. She underwent a median sternotomy, pericardial decompression, and mediastinal debridement. An oesophageal stent was attempted unsuccessfully. The patient refused any more aggressive treatments and was discharged to a hospice where she passed away 13 days after presentation. This case and the associated literature review highlights an unusual presentation of oesophageal cancer and an uncommon cause of cardiac tamponade.

  • pericardial disease
  • oesophageal cancer

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Footnotes

  • Contributors HMAA and UIK were responsible for writing the discussion and background parts. CW and MO were responsible for the case presentation and summary parts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.