Esophageal pericardial fistula following radiation therapy after placement of an esophageal stent: A case report and literature review

Esophageal pericardial fistula is a rare complication of esophageal cancer. This article reports the first documented case of an esophageal pericardial fistula following radiotherapy in the presence of an esophageal stent. A 62-year-old man with advanced esophageal and cardiac cancer underwent radiotherapy after esophageal stent placement and subsequently developed an esophageal pericardial fistula. He was admitted to the hospital with symptoms of epigastric pain and breathlessness. A computed tomography scan of the chest revealed an esophageal pericardial fistula, massive pericardial effusion, and pneumopericardium. The esophagogram revealed esophageal extravasation and an enlarged pericardium. On the basis of these findings, the patient was diagnosed with an esophageal pericardial fistula. His symptoms improved after pericardiocentesis with drainage, nasogastric tube feeding, and short-term antibiotic therapy. Unfortunately, he died 1 month after discharge from the hospital due to sudden massive upper gastrointestinal bleeding.