Bronchopericardial fistula, an unusual complication of oxytetracycline sclerosis therapy.
Here we report a rare case of bronchopericardial fistula following intrapericardial instillation of oxytetracycline. A 63-year-old female patient was admitted for management of malignant pericardial effusion secondary to right-sided bronchogenic carcinoma. Medical therapy and recurrent percutaneous catheter drainage failed in resolving the problem, so subxiphoid pericardiostomy and drainage tube insertion was performed. There was no decrease in the drainage so we decided to perform pericardial sclerosis by intrapericardial tetracycline instillation. After the second time oxytetracycline instillation, the patient developed respiratory arrest with hemodynamic instability. A huge amount of yellow frothy secretion aspirated through the endotracheal tube. The presence of tetracycline in the bronchial secretion was proved by microbiological methods. The hemodynamic status of the patient deteriorated rapidly and despite all resuscitation measures we lost the patient within a few hours.
Grbolar
Adem
A
Department of Cardiovascular Surgery, Gazi University Hospital, Besevler, Ankara, Turkey.
Qaradaghi
Lawand
L
Imren
Yildirim
Y
Tasoglu
Irfan
I
Coskun
Elif
E
Avci
Tugba
T
D001983:Bronchial Fistula / Q000209:etiology* / Q000473:pathology; D002283:Carcinoma, Bronchogenic / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004322:Drainage; D017809:Fatal Outcome; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000473:pathology; D006331:Heart Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D010118:Oxytetracycline / Q000008:administration & dosage*; D010490:Pericardial Effusion / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D010491:Pericardial Window Techniques; D010496:Pericardium / Q000473:pathology*; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000009:adverse effects* / Q000379:methods; D017211:Treatment Failure; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D010118:Oxytetracycline