title: Unusual cause of pericardial effusion.
abstract: A 65-year-old Egyptian lady suffering from non-alcoholic liver cirrhosis was referred to our unit for evaluation of a massive pericardial effusion. Few weeks before presentation, she suffered from progressive abdominal distention and dyspnoea. She denied fever, rigors or other cardiorespiratory symptoms. Examination revealed shrunken liver, spleenomegaly and ascites. Chest was clear to auscultation and heart sounds were distant. Chest radiograph showed cardiomegaly and clear lung fields. Abdominal ultrasound confirmed the results of abdominal examination. Transthoracic echocardiogram (TTE) revealed a massive pericardial effusion (PEF) and rheumatic mitral stenosis. Chest tomography showed PEF and clear lung fields. One litre of exudate was removed via TTE-guided needle pericardiocentesis. A pericardio-peritoneal shunt was suspected, which was confirmed via a radioisotopic study. This case is among very few cases that reported PEF in a cirrhotic ascetic patient secondary to a radio-isotopically confirmed pericardio-peritoneal shunt in the literature.
authors.affiliation: Department of Internal Medicine, Kasr Elaini Hospital-Faculty of Medicine-Cairo University, Cairo, Egypt.
authors.forename: Ragai
authors.initials: R
authors.lastname: Fouda
authors.forename: Hussam
authors.initials: H
authors.lastname: Ammar
authors.forename: Elham
authors.initials: E
authors.lastname: Sobhy
authors.forename: Amr M
authors.initials: AM
authors.lastname: Amin
mesh_terms: D000368:Aged; D004452:Echocardiography; D005260:Female; D005402:Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D010496:Pericardium; D010532:Peritoneal Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging