CTICasesEsophageal-Pericardial Fistula from Esophageal Cancer
Imaging findings
CT scan reveals a severely thickened, fluid-filled esophageal lumen with large mediastinal lymph nodes and a protruding mass invading the posterior wall of the left atrium. The pericardial space is filled with both gas and fluid, showing pericardial thickening and enhancement, consistent with an esophageal-pericardial fistula.
Key takeaways
Esophageal carcinoma can invade adjacent mediastinal structures, leading to devastating complications such as esophageal-pericardial or esophageal-atrial fistulas. The presence of pneumopericardium and hydropenicardium in the setting of an esophageal mass should raise immediate concern for neoplastic erosion and fistula formation.
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