Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan.
Department of Cardiology, National Hospital Organization Takasaki General Medical Center, Japan.
Intern Med. 2024 May 15;63(10):1387-1393. doi: 10.2169/internalmedicine.2502-23. Epub 2023 Oct 13.
A 75-year-old man underwent chemoradiotherapy for advanced esophageal cancer. After nine years, he was hospitalized for left pyothorax. Consequently, the patient underwent drainage and window opening surgery. He experienced cardiopulmonary arrest but was resuscitated. Based on cardiac catheterization data, the patient was diagnosed with constrictive pericarditis. Unfortunately, extracorporeal circulation did not improve his condition, and he ultimately died. An autopsy revealed adhesion between the pericardium and pleura, especially the pericardium in contact with the left thoracic cavity, which was markedly thickened. This suggests that constrictive pericarditis, a latent complication of chemoradiotherapy, is aggravated by pyothorax.
一位 75 岁男性因晚期食管癌接受了放化疗。9 年后，因左侧脓胸住院。随后，患者接受了引流和开窗手术。他发生了心肺骤停，但得到了复苏。根据心导管检查数据，患者被诊断为缩窄性心包炎。不幸的是，体外循环并没有改善他的病情，最终他去世了。尸检显示心包和胸膜之间存在粘连，尤其是与左胸腔接触的心包明显增厚。这表明缩窄性心包炎是放化疗的潜在并发症，脓胸使其加重。
