Percutaneous pericardial drainage removed 650 mL of bloody pericardial fluid and led to symptomatic improvement without re-accumulation in a 72-year-old man with cardiac tamponade secondary to frequent vomiting two months after esophageal cancer surgery.
Case Report (n=1)
No
Cardiac tamponade is a rare but potentially lethal complication that can occur months after esophageal cancer surgery, possibly triggered by physical stress such as frequent vomiting.
72歳，男性．扁平上皮癌と神経内分泌癌の混在型の胸部食道癌に対し，術前化学療法後に鏡視下食道亜全摘・３領域郭清・胃管再建・胸骨後経路を施行した．術後経過は良好で術後14日目に退院した．約２カ月後，夕食後に胸やけを自覚し用手による自己誘発で数回嘔吐し，その後に動悸と全身倦怠感が徐々に増悪したため当院を救急受診した．身体所見では頸静脈怒張と心音減弱，画像所見では心囊液の貯留を認め，心タンポナーデの診断で緊急入院した．保存的加療で軽快せず，エコー下経皮的心囊ドレナージを施行した．心囊液は約650mL，血性で異型細胞や感染徴候は認めなかった．その後症状は軽快し穿刺後７日目にドレナージチューブを抜去し退院した．術後９カ月で肝転移再発を認め，術後14カ月で永眠されたが，縦隔に明らかな再発はなく心囊液の再貯留は認めなかった．食道癌術後約２カ月後に心タンポナーデを発症した症例は非常に稀であり文献的考察を加え報告する．
Yamashita et al. (Wed,) conducted a case report in 72-year-old male patient with esophageal squamous cell carcinoma (cT2N0M0 cStage II) who developed cardiac tamponade secondary to repeated vomiting two months after thoracoscopic subtotal esophagectomy and gastric tube reconstruction (n=1). Percutaneous pericardial drainage was evaluated on Resolution of cardiac tamponade evidenced by symptom improvement and drainage of pericardial fluid. Percutaneous pericardial drainage removed 650 mL of bloody pericardial fluid and led to symptomatic improvement without re-accumulation in a 72-year-old man with cardiac tamponade secondary to frequent vomiting two months after esophageal cancer surgery.