Pneumopericardium: A Rare Complication of Antireflux Surgery
(2023) Journal of Cardiology and Cardiovascular Medicine — Vol. 8, n° 2, p. 104-107 (2023)
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- Abstract
- Pneumopericardium is a rare clinical entity, occurring in the setting of thoracic trauma, malignancies, or mechanical ventilation. Very few cases report pneumopericardium as a complication of gastrointestinal tract surgery. Signs and symptoms may be frustrating, ranging from asymptomatic to chest pain, sepsis, hemodynamic instability, pericarditis, or even cardiac tamponade. Clinical pathognomonic signs of pneumopericardium include pericardial metallic tinkling friction rub and mill wheel murmur. Diagnostic workup includes electrocardiogram, chest radiography, and, computed tomography imaging. A gastro pericardial fi stula should be considered a rare diff erential diagnosis for acute chest pain in patients with a history of gastroesophageal surgery. Rapid recognition and treatment avoid life-threatening complications. The successful outcome of gastro pericardial fi stula treatment depends on both emergency and defi nitive surgical management. The survival rate with conservative management is poor. We present the case of a 78-year-old patient suff ering from pneumopericardium and pericardial infusion, due to a fi brotic fi stula between the Nissen’s valve, occurring 10 years after redo antirefl ux surgery. Treatment included broad-spectrum antibiotics, and emergency surgery for pericardial drainage, biopsy of the valve’s defect, suture, and omentoplasty.
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Diquas, E., Druez, A., & Dili, A. (2023). Pneumopericardium: A Rare Complication of Antireflux Surgery. Journal of Cardiology and Cardiovascular Medicine, 8(2), 104-107. https://doi.org/10.29328/journal.jccm.1001161 (Original work published 2023)