Department of Respiratory and Critical Care Medicine, Shengli Oilfield Central Hospital, No.31 Jinan Road, Dongying City, 257034, Shandong Province, China.
BMC Pulm Med. 2024 Oct 24;24(1):529. doi: 10.1186/s12890-024-03358-2.
Tracheopericardial fistula is an extremely rare clinical condition caused by lung disease penetrating the tracheal wall and extending to the pericardial cavity, forming a fistula between the airway and the pericardial cavity. Since the pericardial cavity communicates with the respiratory tract, gases, airway secretions and pathogens can enter the cavity, leading to pneumopericardium, effusion and abscess. In severe cases, it can result in cardiac tamponade and cardiogenic shock. Only a few cases of TPF have been reported in the literature. In this report, a 72-year-old man with recurrent lung cancer presented with fever, chest tightness and chest pain. Electrocardiogram showed ST-segment elevation in multiple leads, resembling an acute myocardial infarction. Emergency coronary angiography did not reveal significant stenosis. Further examination with chest computed tomography and bronchoscopy revealed pericardial effusion and a tracheal fistula, leading to the final diagnosis of TPF as a complication of lung cancer. This case aims to enhance understanding and recognition of this clinical entity to reduce misdiagnosis.
气管-心包瘘是一种极为罕见的临床病症，由肺部疾病穿透气管壁并延伸至心包腔，在气道和心包腔之间形成瘘管。由于心包腔与呼吸道相通，气体、气道分泌物和病原体可进入其中，导致气胸、积液和脓肿。在严重的情况下，它可导致心脏压塞和心源性休克。仅有少数几例 TPF 病例在文献中报道。在本报告中，一名 72 岁的复发性肺癌男性患者出现发热、胸闷和胸痛。心电图显示多个导联 ST 段抬高，类似于急性心肌梗死。紧急冠状动脉造影未发现明显狭窄。进一步的胸部计算机断层扫描和支气管镜检查显示心包积液和气管瘘，最终诊断为 TPF，是肺癌的并发症。本病例旨在增强对这一临床实体的理解和认识，以减少误诊。
