title: Esophageal-left atrial fistula: an unsual cause.
abstract: A 55-year-old male presented with progressive dyspnea, swelling of legs and abdominal distension for past one week. Routine investigation showed presence of large pericardial effusion. Pericardiocentesis tapped a yellow colored sterile fluid with predominant polymorphs. However sequence of events following pericardiocentesis were unusual as patient developed stroke. MRI brain and CECT thorax were done. MRI brain showed small infarct and CECT showed presence of open safety pin eroding through esophagus and communicating with left atrium with thrombus and an air pocket within. Patient developed progressive encephalopathy and CT brain revealed multiple infarcts with pneumocephalus.
authors.affiliation: Department of Cardiology, Heart And General Hospital, Jaipur, India.
authors.forename: Bhavesh
authors.initials: B
authors.lastname: Meel
authors.affiliation: Department of Cardiology, Heart And General Hospital, Jaipur, India.
authors.forename: Prakash
authors.initials: P
authors.lastname: Chandwani
authors.affiliation: Department of Cardiology, Mount Sinai Hospital, New York, UNITED STATES. Electronic address: drravindersinghrao@yahoo.co.in.
authors.forename: Ravinder Singh
authors.initials: RS
authors.lastname: Rao
authors.affiliation: Department of Cardiology, Heart And General Hospital, Jaipur, India.
authors.forename: Sudhir Kumar
authors.initials: SK
authors.lastname: Vyas
mesh_terms: D018450:Disease Progression; D004937:Esophageal Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D020519:Pericardiocentesis / Q000379:methods; D035583:Rare Diseases; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Fistula; Left atrial thrombus; Pericardial effusion