Abstract
IntroductionWe present a patient with a fatal late esophago-pericardial fistula three months after dilatation for benign oesophagus stenosisCase presentationA 71-year-old caucasian male with a known benign esophagus stenosis was referred to the ICU. On arrival an asystole developed which proved to be due to a large pericardial effusion. Pericardial fluids were drained, but the patients' condition worsened and he died due to multiple organ failure. Postmortum investigation revealed an esophago-pericardial fistula.ConclusionCauses of an acute tamponade should also be sought in semirecent events, such as manipulation to the oesophagus months before the acute critical illness.
Highlights
We present a patient with a fatal late esophago-pericardial fistula three months after dilatation for benign oesophagus stenosisCase presentation: A 71-year-old caucasian male with a known benign esophagus stenosis was referred to the intensive care unit (ICU)
Cardiac tamponade can be caused by pericardial effusion and should always be considered whenever asystole is present
Esophagus dilatation is performed on a regular basis for benign stenotic conditions
Summary
Cardiac tamponade can be caused by pericardial effusion and should always be considered whenever asystole is present. Fistula of the esophagus to the pericardial space have been described before and could cause infectious pericarditis with effusion. A 71-year-old Caucasian male, was referred to our clinic because of high fever (39.2°C) His medical history showed benign esophagus stenosis due to recurrent reflux disease and concomitant candida esophagitis. A new ultrasound of the heart showed again pericardial effusion, in which a small catheter was placed to perform drainage. His clinical condition worsened further and he died a few hours later due to hemodynamic shock unresponsive to therapy. Post-mortem culture of the pericardial effusion showed candida species
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