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Pericarditis with effusion complicating esophageal perforation

J R Hankins, J S McLaughlin

    The Journal of Thoracic and Cardiovascular Surgery
    |February 1, 1977
    PubMed
    Summary

    Esophageal perforation can lead to life-threatening pericarditis with effusion, particularly with delayed diagnosis and treatment. Early suspicion and intervention are crucial for improving patient outcomes in these complex cases.

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    Area of Science:

    • Cardiology
    • Thoracic Surgery
    • Gastroenterology

    Background:

    • Esophageal perforation is a serious condition requiring prompt management.
    • Complications such as pericarditis with effusion can arise, posing significant risks.

    Observation:

    • Three cases of pericarditis with effusion following esophageal perforation were identified over six years.
    • Delayed diagnosis of both perforation and subsequent pericarditis complicated management.

    Findings:

    • Delayed diagnosis and treatment of esophageal perforation led to empyema in all three patients.
    • Mediastinitis, pleuritis, and pneumonia obscured the cardiac silhouette, hindering pericarditis diagnosis on chest X-rays.
    • Pericardial decompression was successful in two patients who survived.

    Implications:

    • A high index of suspicion for pericarditis is essential in esophageal perforation patients, especially with delayed presentation.
    • Prompt diagnosis and treatment of esophageal perforation are critical to prevent severe complications like pericarditis.
    • Improved diagnostic strategies are needed to identify pericarditis earlier in the context of esophageal perforation.

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