Purulent pericarditis with atypical organisms like Candida should raise suspicion for an oesophago-pericardial fistula, which can be diagnosed via endoscopy.
Oesophageal fistula warrants consideration in atypical purulent pericarditis; case report leaves open whether endoscopy should enter routine workup.
. Oesophagogastroduodenoscopy was performed and revealed a small fistula in the proximal oesophagus extending into the retrocardiac space. Multiple biopsy specimens of the fistula site and oesophageal stricture were obtained. Histopathological findings were consistent with poorly differentiated squamous cell carcinoma of the oesophagus complicated by fistulation to the retrocardiac space. LEARNING POINTS: Purulent pericarditis with atypical organisms should raise the suspicion of oesophago-pericardial fistula.Oesophago-pericardial fistula in oesophageal squamous cell carcinoma is rare and associated with high mortality and a poor prognosis.This is one of the few cases where a gastro-pericardial fistula has been diagnosed by endoscopy.
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Ghunaim et al. (2022) studied this question.
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