Oesophageal-pericardial fistula: a rare complication of radiation-induced oesophagitis

Eur J Cardiothorac Surg. 2020 Nov 1;58(5):1097-1099. doi: 10.1093/ejcts/ezaa173.

Abstract

Oesophageal-pericardial fistula after radiation therapy for lung cancer is a rare complication associated with a high mortality. In this case report, we present the case of 52-year-old women with late radiation-induced oesophagitis after chemoradiotherapy for a pulmonary adenocarcinoma, complicated by an oesophageal-pericardial fistula for which a transthoracic oesophagectomy with pericardial drainage was performed. The postoperative course was complicated by a fatal hypovolaemic shock due to a perforation of the descending aorta near the initial fistula track. In this case report, we illustrate the importance of thorough inspection of diagnostic images in this context and emphasize the role of endovascular repair in case an associated aortic perforation is suspected.

Keywords: Aorta perforation; Oesophageal-pericardial fistula; Radiation therapy.

Publication types

  • Case Reports

MeSH terms

  • Esophageal Fistula* / diagnostic imaging
  • Esophageal Fistula* / etiology
  • Esophagectomy
  • Esophagitis*
  • Female
  • Humans
  • Middle Aged
  • Pericardium / diagnostic imaging
  • Thoracic Surgical Procedures*