J 2024

Acute Pericarditis as a Complication of Hiatal Hernia Perforation

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

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.200 in 2022

Organization unit

Faculty of Medicine

DOI

UT WoS

001299130700005

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 23/9/2024 14:23, Mgr. Tereza Miškechová

Abstract

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.