Rare atypical presentation of a polymicrobial gastropericardial fistula.
BMJ Case Rep
; 15(9)2022 Sep 19.
Article
in English
| MEDLINE | ID: covidwho-2038272
ABSTRACT
We present the unique case of a gastropericardial fistula with a rare, delayed presentation in a man in his 70s. Relevant surgeries include Watchman Left Atrial Appendage Closure device placement 1 year prior to arrival and gastric bypass surgery 20 years prior to arrival. The patient presented to the emergency department with weakness, diarrhoea and left knee pain. He was admitted for cellulitis of the left lower extremity, prosthetic septic arthritis of the left knee and group G streptococcus bacteraemia. His hospital course was complicated by acute chest pain and dyspnoea. Imaging revealed pneumopericardium. Oesophagogastroduodenoscopy visualisation confirmed the diagnosis of gastropericardial fistula. The patient could not be transferred to a tertiary centre for definitive management because of the effect of the COVID-19 pandemic on tertiary hospital volumes. After pericardial drainage and administration of antimicrobials without improvement, the patient was discharged to hospice care at his request and died 1 day after discharge.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumopericardium
/
Gastric Fistula
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Limits:
Humans
/
Male
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Bcr-2022-250093
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