Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esophagopericardial fistula is a rare complication of benign esophageal disease. It has not previously been described occurring in achalasia. The authors present such a case. This cause should be considered in the differential diagnosis of pneumopericardium in patients with achalasia. Early diagnosis is stressed and esophagoscopic examination should be performed if the result of barium swallow test is negative.
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PMID:Pneumopericardium occurring as a complication of achalasia. 373 6

We describe a case of pneumopericardium that resulted from esophagopericardial fistula occurring at the 22nd years after operation for achalasia in a 52-year-old male. Atypical features on initial examination suggested myopericarditis or congestive heart failure. A chest roentgenogram and computed tomography revealed development of pneumopericardium. Subsequent emergent pericardiocentesis relieved cardiac tamponade and enabled us to diagnose pyopneumopericardium and esophagopericardial fistula in postoperative period. The esophagopericardial fistula was surgically closed. However, the patient died 2 weeks postoperation of hemorrhage from duodenal ulcer. Autopsy confirmed the pre-mortem diagnosis of esophagopericardial fistula without evidence of malignancy. Early diagnosis and subsequent treatment appears to be most important. This case report reinforces the difficulty of this diagnosis and perhaps the need for clinical awareness and inclusion of this entity in a differential diagnosis.
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PMID:[Esophagopericardial fistula occurring at the 22nd years after operation for achalasia presenting as myopericarditis]. 1188 13

Per-oral endoscopic myotomy (POEM) is a relatively novel endoscopic technique for the treatment of achalasia. POEM has been shown to have outcomes comparable to those with Heller myotomy, but it is less invasive and has fewer complications. A 72-year-old man with progressive solid and liquid dysphagia underwent POEM, but soon after the procedure went into cardiac arrest; spontaneous circulation returned after 10 minutes of CPR. He was subsequently found to have tension pneumopericardium as a result of the inadvertent use of air instead of carbon dioxide during the procedure. He had a prolonged hospitalization that required an extended stay in the medical intensive care unit. Although rare, POEM can lead to critical, life-threatening complications.
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PMID:Pneumopericardium Complicating Per-Oral Endoscopic Myotomy Due to Inadvertent Use of Air Instead of Carbon Dioxide. 3014 82