Pyopneumopericarditis from a gastropericardial fistula: a case report. Issue 11 (15th November 2021)

• Record Type: Journal Article
• Authors: Lee, John; Ramkumar, Satish; Ha, Phil; Raghunath, Ajay; Dundon, Benjamin
• Editors: Dastidar, Amardeep Ghosh; Bernstein, Brett Sydney; Vervaat, Fabienne
• Is Part Of: European heart journal. Volume 5:Issue 11(2021)
• Publication Date: 2021-11-15
• Subjects: Case report -- Pyopneumopericardium -- Pyopneumopericarditis -- Murmur -- Echocardiography; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab408
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Pyopneumopericarditis is a very rare diagnosis that requires prompt recognition and urgent treatment. It denotes the presence of pus and air in the pericardium with associated inflammation of the fibrous pericardial sac. Case summary: A 49-year-old gentleman was admitted with pyopneumoperciarditis on a background of a previous uncomplicated Roux-en-Y gastric bypass surgery performed 7 years prior. He underwent emergency surgery for an omental patch repair of an ulcer perforation involving the diaphragm and pericardium. His inpatient stay was complicated by persistent seropurulent output from the pericardial drain, loculated pleural effusion, and deconditioning. Discussion: Management is extrapolated from the literature regarding purulent pericarditis. This condition albeit rare, requires swift recognition as without treatment mortality approaches 100%. Colchicine is an important adjunctive therapy postoperatively to prevent constrictive physiology.