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Fish bone leads to acute pericarditis: correct diagnosis and successful treatment

Eine Fischgräte führt zu einer akuten Perikarditis – richtige Diagnose und erfolgreiche Behandlung

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Abstract

Background

Although esophageal perforation rarely occurs after foreign body ingestion, perforations in the esophagus can lead to serious complications such as pericarditis.

Case report

This is a case report of a 48-year-old man without any cardiovascular risk factors who presented to the emergency department with chest pain. The typical electrocardiogram and thoracic computed tomography changes were helpful in establishing the diagnosis of acute pericarditis, which was due to the migration of a fish bone through the esophagus and extending into the left atrium.

Conclusion

We successfully diagnosed this patient with acute pericarditis, which was due to the migration of a fish bone through the esophagus and extending into the left atrium. Our thoracic surgeon colleagues removed the foreign body via thoracotomy. He was extubated on day 11, and no chest pain or dyspnea during a six-month follow-up period. A review of the literature revealed similar cases with unsuspected foreign body ingestion, in which the patients presented to the emergency department with various symptoms suggestive of acute pericarditis.

Zusammenfassung

Hintergrund

Eine Perforation der Speiseröhre tritt während der Aufnahme von Fremdkörpern zwar selten auf, kann aber zu schwerwiegenden Komplikationen wie Perikarditis führen.

Fallbericht

Ein 48-jähriger Patient ohne kardiovaskuläre Risikofaktoren stellte sich mit Brustschmerzen in der Notaufnahme vor. Die typischen Veränderungen im Elektrokardiogramm und der Computertomographie des Thorax waren bei der Diagnose einer akuten Perikarditis hilfreich. Sie war auf die Migration einer Fischgräte durch die Speiseröhre bis zum linken Vorhof zurückzuführen.

Schlussfolgerung

Bei unserem Patienten konnte eine akute Perikarditis diagnostiziert werden, die auf die Migration einer Fischgräte durch die Speiseröhre bis zum linken Vorhof zurückzuführen war. Unsere Kollegen vom Thoraxchirurgen haben den Fremdkörper mittels Thorakotomie entfernt. Er wurde am 11. Tag extubiert und hatte während einer sechsmonatigen Nachbeobachtungszeit keine Schmerzen in der Brust oder Atemnot. Eine Literatursuche ergab ähnliche Fälle mit unerwarteter Aufnahme von Fremdkörpern. Die Patienten suchten die Notaufnahme mit verschiedenen Symptomen auf, die auf eine akute Perikarditis hinwiesen.

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Authors and Affiliations

  1. Department of Cardiovascular Center, The First Hospital of Jilin University, No. 71 Xinmin Street, 130021, Changchun, Jilin, China

    Lu Gao &  Liping Chen

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  1. Lu Gao
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  2. Liping Chen
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Correspondence to Liping Chen.

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Conflict of interest

L. Gao and L. Chen have no financial or proprietary interests in any material discussed in this article.

This is an observational study. The First Hospital of Jilin University Research Ethics Committee has confirmed that no ethical approval is required.

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Gao, L., Chen, L. Fish bone leads to acute pericarditis: correct diagnosis and successful treatment. Notfall Rettungsmed 24 (Suppl 1), 39–42 (2021). https://doi.org/10.1007/s10049-021-00872-2

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