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Eur J Cardiothorac Surg 2001;20:1267-1269
© 2001 Elsevier Science NL

Case report

Delayed diagnosis of purulent pericarditis caused by esophagopericardial fistula by computed tomography scan and echocardiography

Departments of Thoracic and Cardiovascular Surgery and Cardiology, Wonkwang University Hospital, Iksan, South Korea

Received 11 July 2001; received in revised form 24 September 2001; accepted 27 September 2001.

Corresponding author. Tel.: +82-63-8501275; fax: +82-63-8570252
e-mail: jobchoi{at}wonnms.wonkwang.ac.kr

We report a case of esophagopericardial fistula with subsequent purulent pericarditis that was diagnosed with computed tomography and echocardiography. In a patient with non-specific chest pain and vague past history, serial echocardiography demonstrated rapid aggravation of pyopneumopericardium and chest CT scan showed a foreign body that caused the fistula in the esophageal wall. Removal of a piece of fish bone, closure of the fistula, and creation of a pericardial window for continuous drainage were performed through a low lateral thoracotomy.

Key Words: Esophago-pericardial fistula • Suppurative pericarditis • Foreign body • Fish bone