Pyopneumopericardium Attributed to an Esophagopericardial Fistula: Report of a Survivor and Review of the Literature WAYNE L. MILLER, M.D., MICHAEL J.

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Presentation transcript:

Pyopneumopericardium Attributed to an Esophagopericardial Fistula: Report of a Survivor and Review of the Literature WAYNE L. MILLER, M.D., MICHAEL J. OSBORN, M.D., LAWRENCE J. SINAK, M.D. Mayo Clinic Proceedings Volume 66, Issue 10, Pages 1041-1045 (October 1991) DOI: 10.1016/S0025-6196(12)61728-5 Copyright © 1991 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Posteroanterior chest roentogenogram obtained at time of admission of 79-year-old man, depicting enlargement of cardiac silhouette, bilateral pleural effusions, and prominent pulmonary vasculature. Mayo Clinic Proceedings 1991 66, 1041-1045DOI: (10.1016/S0025-6196(12)61728-5) Copyright © 1991 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Posteroanterior chest roentgenogram of 79-year-old man obtained on eighth day of hospitalization, demonstrating increased pleural effusion on left cardiac enlargement and air within pericardium (arrowhead). Mayo Clinic Proceedings 1991 66, 1041-1045DOI: (10.1016/S0025-6196(12)61728-5) Copyright © 1991 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Computed tomographic scan of thorax of 79-year-old man, showing pneumopericardium. Air within pericardium (arrowheads) is located anterior, lateral, and posterior to heart. Mayo Clinic Proceedings 1991 66, 1041-1045DOI: (10.1016/S0025-6196(12)61728-5) Copyright © 1991 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Apical four-chamber view two-dimensional echocardiograms in 79-year-old man. A, Moderately large pericardial effusion (arrowheads) that contains multiple small densities consistent with appearance of microbubbles within pericardium. B, Evidence of tamponade in conjunction with systolic compression of right atrium (arrow). LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle. Mayo Clinic Proceedings 1991 66, 1041-1045DOI: (10.1016/S0025-6196(12)61728-5) Copyright © 1991 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 5 A, Radiographic constrast study with use of meglumine diatrizoate, depicting anterior midesophageal fistula (arrowhead) in 79-year-old man. B, Selected view of fistulous tract (arrowheads) in same patient. Mayo Clinic Proceedings 1991 66, 1041-1045DOI: (10.1016/S0025-6196(12)61728-5) Copyright © 1991 Mayo Foundation for Medical Education and Research Terms and Conditions