Acute Pericarditis as a Complication of Hiatal Hernia
Perforation

BRANNY, Piotr, Radim SPACEK, David VICIAN, Alica CESNAKOVÁ-KONEČNÁ and Matej PEKAŘ. Acute Pericarditis as a Complication of Hiatal Hernia Perforation. Cureus Journal of Medical Science. LONDON: SPRINGERNATURE, 2024, vol. 16, No 8, p. 1-8. ISSN 2168-8184. Available from: https://dx.doi.org/10.7759/cureus.67551.

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TY  - JOUR
ID  - 2424797
AU  - Branny, Piotr - Spacek, Radim - Vician, David - Cesnaková-Konečná, Alica - Pekař, Matej
PY  - 2024
TI  - Acute Pericarditis as a Complication of Hiatal Hernia Perforation
JF  - Cureus Journal of Medical Science
VL  - 16
IS  - 8
SP  - 1-8
EP  - 1-8
PB  - SPRINGERNATURE
SN  - 21688184
KW  - fistula
KW  - mods
KW  - septical
KW  - stercoral
KW  - transverse colon
KW  - hiatal hernia
KW  - pericarditis
UR  - https://www.cureus.com/articles/281167-acute-pericarditis-as-a-complication-of-hiatal-hernia-perforation#!/
N2  - 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.
ER  -

Basic information
Original name	Acute Pericarditis as a Complication of Hiatal Hernia Perforation
Authors	BRANNY, Piotr, Radim SPACEK, David VICIAN, Alica CESNAKOVÁ-KONEČNÁ and Matej PEKAŘ (703 Slovakia, guarantor, belonging to the institution).
Edition	Cureus Journal of Medical Science, LONDON, SPRINGERNATURE, 2024, 2168-8184.

Other information
Original language	English
Type of outcome	Article in a journal
Field of Study	30201 Cardiac and Cardiovascular systems
Country of publisher	United States of America
Confidentiality degree	is not subject to a state or trade secret
WWW	URL
Impact factor	Impact factor: 1.200 in 2022
Organization unit	Faculty of Medicine
Doi	http://dx.doi.org/10.7759/cureus.67551
UT WoS	001299130700005
Keywords in English	fistula; mods; septical; stercoral; transverse colon; hiatal hernia; pericarditis
Tags	14110515, rivok
Tags	International impact, Reviewed
Changed by	Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 23/9/2024 14:23.

Abstract

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.

PrintDisplayed: 6/10/2024 13:16

Acute Pericarditis as a Complication of Hiatal Hernia Perforation

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