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Ludovic Fournel, Francesco Decembrino, Massimiliano Paci, Filippo Lococo, Massive pneumopericardium as onset symptom of fistulizing oesophageal cancer, European Journal of Cardio-Thoracic Surgery, Volume 54, Issue 1, July 2018, Page 194, https://doi.org/10.1093/ejcts/ezy006
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An 84-year-old man presented with cardiogenic shock. A computed tomography scan revealed a massive pneumopericardium (A), and an emergency computed tomography-guided drain (red arrow, B) evacuated air and turbid fluid. An oral-contrast computed tomography scan detected a pericardial opacification through an oesophagopericardial fistulation (red arrows, C) of a previously unknown oesophageal tumour, as subsequently confirmed at endoscopy (white arrows, D). A coated expandable metal stent was placed (E), but, despite intensive care therapy, the patient died 4 days later due to uncontrolled sepsis.