J 2024

Acute Pericarditis as a Complication of Hiatal Hernia Perforation

BRANNY, Piotr, Radim SPACEK, David VICIAN, Alica CESNAKOVÁ-KONEČNÁ, Matej PEKAŘ et. al.

Základní údaje

Originální název

Acute Pericarditis as a Complication of Hiatal Hernia Perforation

Autoři

BRANNY, Piotr, Radim SPACEK, David VICIAN, Alica CESNAKOVÁ-KONEČNÁ a Matej PEKAŘ (703 Slovensko, garant, domácí)

Vydání

Cureus Journal of Medical Science, LONDON, SPRINGERNATURE, 2024, 2168-8184

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 1.200 v roce 2022

Organizační jednotka

Lékařská fakulta

DOI

UT WoS

001299130700005

Klíčová slova anglicky

fistula; mods; septical; stercoral; transverse colon; hiatal hernia; pericarditis

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 23. 9. 2024 14:23, Mgr. Tereza Miškechová

Anotace

V originále

Acute pericarditis is a serious and potentially fatal disease in which a diagnostic workup is not always straightforward. Hiatal hernia, on the other hand, is often asymptomatic and can be easily diagnosed if symptomatic. In advanced forms of hiatal hernia, oppression of intrathoracic organs and heart failure can occur. In uncommon cases, the large intestine can also be translocated into the chest cavity, and very rarely, it can be perforated with the development of mediastinitis and/or pericarditis. We report the case of a 74- year-old female with a 1.5-month history of chest pain with elevated inflammatory markers. This patient was empirically treated with antibiotics for suspected pneumonia. After a few weeks, due to a worsening of the patient's condition, an echocardiogram and then a CT of the chest were performed, showing a large hiatal hernia and a very probable purulent pericarditis, necessitating a surgical exploration. A cardiac surgeon found stercoral contents in the pericardium, with a fistula at the apex of the heart. The operation continued with an exploration of the abdominal cavity; the general surgeon returned the massive hiatal hernia to the abdomen, the contents of which were the stomach and transverse colon. An extensive perforation in the transverse colon was found. Lavage, drainage, and resection of the affected part of the intestine were performed, and a permanent (terminal) colostomy was constructed. The patient was in severe septic shock with multiorgan failure and died 10 hours after surgery despite maximal therapy. This case highlights the importance of interdisciplinary cooperation and the importance of considering the possible fistula in the co-occurrence of hiatal hernia and pericarditis.