Eur J Cardiothorac Surg 2002;22:1007
© 2002 Elsevier Science NL
Images in cardio-thoracic surgery |
Purulent pneumopericarditis due to ulcer of the retrosternal stomach roll after esophagectomy
Toshiki Matsubara*
Department of Surgery, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-Ku, Tokyo 170, Japan
Received 14 July 2002;
accepted 26 August 2002.
* Tel. +81-3-3918-0111; fax: +81-3-3586-6305
e-mail: matsu-bara{at}umin.ac.jp
Key Words: Gastropericardial fistula • Purulent pericarditis • Esophageal reconstruction • Constrictive pericarditis • Ulcer of the stomach roll • Esophageal cancer
A 57-year-old man, who had undergone subtotal esophagectomy and bowel reconstruction with a stomach roll located in the retrosternal space 4 years before, developed pneumopericardium (Fig. 1)
due to ulcer perforation (Fig. 2)
. He is alive and well 8 years after partial gastrectomy and pericardial drainage followed by pericardiectomy for secondary constrictive pericarditis.
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Fig. 1. Chest X-ray film at admission to our hospital 5 days after the onset of the symptoms demonstrated free air in the thickened pericardium.
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Fig. 2. A large gastropericardial fistula was demonstrated on esophagography and computed tomography. A perforation ulcer measuring 30 by 40 mm in diameter was found at the prompt emergency operation.
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