Hankins J R, McLaughlin J S
J Thorac Cardiovasc Surg. 1977 Feb;73(2):225-30.
Among 24 patients with esophageal perforation treated during the past 6 years, 3 patients developed pericarditis with effusion as a life-threatening complication. In the first patient pericarditis was found at autopsy, the diagnosis having been suspected but not proved during life. In the other 2 patients pericardial decompression was performed and both survived. Common denominators in the 3 patients were delayed diagnosis and treatment of the perforation, with resultant empyema. Further, the diagnosis of pericarditis with effusion was difficult and delayed, because mediastinitis and associated pleuritis and pneumonia obscured the cardiac silhouette on chest roentgenogram. It is recommended that a high index of suspicion of pericarditis be maintained in patients with esophageal perforation, especially in those in whom the perforation is diagnosed late.
在过去6年中接受治疗的24例食管穿孔患者中，有3例发生心包炎伴积液，这是一种危及生命的并发症。第一例患者心包炎是在尸检时发现的，生前虽怀疑有此诊断但未得到证实。另外2例患者接受了心包减压术，均存活下来。这3例患者的共同特点是穿孔诊断和治疗延迟，导致了脓胸。此外，心包炎伴积液的诊断困难且延迟，因为纵隔炎以及相关的胸膜炎和肺炎使胸部X线片上的心影模糊不清。建议对食管穿孔患者，尤其是那些穿孔诊断较晚的患者，保持对心包炎的高度怀疑指数。
