Summary
Perikardiale und kardiale Fisteln stellen eine seltene Komplikation von Ösophagus- und Magentumoren dar. Wir berichten über einen 50-jährigen Patienten mit einer 10-monatigen Anamnese eines distalen Ösophaguskarzinoms mit Lungen- und Lebermetastasen, der uns nach 6 Zyklen einer palliativen Chemotherapie Anfang März 2004 überwiesen worden war. Der Patient stellte sich wegen Dysphagie, Dyspnoe, Tachykardie und Hypotension vor. Ein eitriger Perikarderguss und beidseitige Pleuraergüsse wurden diagnostiziert und der Patient mit Antibiotika, wiederholten Pleurapunktionen und einer Perikarddrainage mit Polihexanid Spülung behandelt. Eine Ösophagogastroduodenoskopie, ein PeritrastR-Schluck und eine Computertomographie wiesen eine maligne ösophago-pleuro- perikardiale Fistel nach. Es wurden insgesamt drei beschichtete expandierbare Metallstents in den Ösophagus implantiert, die die Fistel erfolgreich abdichteten. Leider verstarb der Patient drei Monate später an seinem Karzinom.
Zusammenfassung
Pericardial and cardiac fistulae secondary to oesophageal or gastric tumours are a rare complication. We report about a 50-year-old male patient with a 10-month history of distal oesophageal carcinoma with lung and liver metastases who was referred to our hospital after 6 cycles of palliative chemotherapy at the beginning of March 2004. The patient presented with dysphagia, dyspnea, tachycardia, and hypotension. Purulent pericardial and bilateral pleural effusion was diagnosed, and the patient was treated with antibiotics, repeated pleurocentesis and pericardial drainage with daily polihexanide lavage. Oesophagogastroduodenoscopy, Peritrast™ swallow and computed tomographic scans of chest revealed a malignant oesophago-pleuro-pericardial fistula. A total of three coated, expandable metal stents were inserted into the oesophagus, which sealed successfully the fistula. Unfortunately, the patient succumbed to his carcinoma three months later.
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Abbreviations
- BMI:
-
body mass index
- HR:
-
heart rate
- ICU:
-
intensive care unit
- RR:
-
respiratory rate
- UICC:
-
Union Internationale Contre le Cancer
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Wiedmann, M., Hagendorff, A., Böhm, R. et al. Malignant oesophago-pleuro-pericardial fistula in a patient with oesophageal carcinoma. ZS Kardiologie 94, 411–414 (2005). https://doi.org/10.1007/s00392-005-0235-0
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DOI: https://doi.org/10.1007/s00392-005-0235-0