Abdullah Hafez Mohammad Ammar, Khan Uzma Ikhtiar, Wasekar Chetan, Omar Muhammad
Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.
Internal Medicine, Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan.
BMJ Case Rep. 2019 Jul 17;12(7):e229634. doi: 10.1136/bcr-2019-229634.
Pericardial effusions resulting in a cardiac tamponade have previously been reported with oesophageal cancers. However, most of these cases have been reported in association with radiation and chemotherapy. Rarely as oesophageal pericardial fistuls (OPF) have been reported as the culprits in causing pericardial effusions in patients with oesophageal cancers. Here we present the case of a 61-year-old woman who presented clinically with cardiac tamponade. She was found to have an OPF due to oesophageal squamous cell cancer that resulted in a purulent pericardial effusion. She underwent a median sternotomy, pericardial decompression, and mediastinal debridement. An oesophageal stent was attempted unsuccessfully. The patient refused any more aggressive treatments and was discharged to a hospice where she passed away 13 days after presentation. This case and the associated literature review highlights an unusual presentation of oesophageal cancer and an uncommon cause of cardiac tamponade.
此前有报道称，食管癌可导致心包积液并引发心脏压塞。然而，这些病例大多与放疗和化疗有关。很少有报道称食管心包瘘（OPF）是食管癌患者心包积液的病因。在此，我们报告一例61岁女性患者，其临床表现为心脏压塞。她被发现患有因食管鳞状细胞癌导致的OPF，进而引发了脓性心包积液。她接受了正中胸骨切开术、心包减压和纵隔清创术。尝试放置食管支架但未成功。患者拒绝接受更积极的治疗，出院后前往临终关怀机构，入院13天后去世。该病例及相关文献综述凸显了食管癌的一种不寻常表现以及心脏压塞的一种罕见病因。
