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Colo-pericardial fistula: complication of colonic interposition

L Wetstein1, M A Ergin, R B Griepp

  • 1Department of Cardiothoracic Surgery, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York 11203, USA.

Texas Heart Institute Journal
|September 1, 1982
PubMed

Insights

A rare complication of colonic interposition, a colo-pericardial fistula, was treated successfully. Aggressive surgical intervention in this esophageal replacement case prevented a fatal outcome.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Thoracic Surgery

Background:

  • Esophageal replacement using colonic interposition is a reconstructive surgery.
  • Complications, though rare, can arise years after the procedure.

Purpose of the Study:

  • To report a unique complication of colonic interposition: colo-pericardial fistula.
  • To highlight the importance of prompt surgical management for this rare condition.

Main Methods:

  • Case report of a 22-year-old male with a history of colonic interposition for esophageal replacement.
  • Diagnostic workup including barium swallow.
  • Surgical intervention: thoracotomy, colon removal, pericardiectomy, and subsequent left colonic interposition.

Main Results:

  • A colo-pericardial fistula with massive pericarditis was diagnosed 15 years post-right colonic interposition.
  • The patient survived emergency thoracotomy and pericardiectomy.
  • A subsequent left colonic interposition was successful.

Conclusions:

  • Colonic interposition can lead to rare but life-threatening complications like colo-pericardial fistula.
  • Immediate and aggressive surgical treatment is crucial for survival.
  • Successful reconstruction is possible even after severe complications.

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