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Gastropericardial fistula induced acute purulent pericarditis

  • Boyang Ni
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
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  • Yu-Long Chen
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
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  • Po-Chen Lin
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
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  • Yueh-Tseng Hou
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
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  • Yaw-Tsan Ho
    Correspondence
    Corresponding authors at: Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
    Search for articles by this author
  • Meng-Yu Wu
    Correspondence
    Corresponding authors at: Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
    Search for articles by this author
Published:February 10, 2021DOI:https://doi.org/10.1016/j.ajem.2021.02.006

      Abstract

      Gastropericardial fistula is a rare but lethal condition. Several etiologies have been reported, including previous gastric or esophageal surgery, malignancy, trauma, infection, and ulcer perforation. Typical symptoms included chest pain, epigastric pain, fever and dyspnea. Gastropericardial fistula can lead to serious complications, including cardiac tamponade, sepsis, hemodynamic compromise and death. Therefore, early diagnosis and timely management are important for physicians to prevent from catastrophic complications. Here, we present a case of a man who presented with acute purulent pericarditis secondary to a gastropericardial fistula to highlight the pathogenesis and suggest therapeutic strategies.

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