A rare case of purulent pericarditis arising from a hepato‑pericardial fistula
Khaled Alaboud Alkheder1
, Omar Farooq Al‑Nahhas1, Yousif Basim Al‑Khafaji1, Ammar Alshirazi Alssabagh2, Sudarshana Reddy Thiyyagura1
1Department of Emergency, Tawam Hospital, Al Ain, UAE
2Department of General Surgery, Tawam Hospital, Al Ain, UAE
Keywords: Bacterial infections, echocardiography, Enterobacter infections, hepatic abscess, hepato‑pericardial fistula, multidisciplinary care, pericardial effusion, pericardiectomy, purulent pericarditis, sepsis
Abstract
Purulent pericarditis is a rare but severe complication of bacterial pericarditis, often secondary to intrathoracic infections, and can cause a hepatic abscess that ruptures into the pericardium, which is an uncommon symptom with a high mortality rate if untreated. We report on a 52 year old man with a poorly differentiated hepatocellular carcinoma who presented with chest pain and pericardial effusion caused by a hepato pericardial fistula. Imaging revealed hepatic microabscesses extending into the pericardium. The patient underwent a pericardial window procedure with purulent fluid drainage and was treated with meropenem for Enterobacter cloacae. Postoperatively, the bilateral pleural effusions required chest drains. After 3 weeks of multidisciplinary care, the patient was discharged in a stable condition. This case highlights the importance of early diagnosis and a multidisciplinary approach in managing rare complications of purulent pericarditis caused by hepatic abscesses. Timely surgical intervention and appropriate antibiotic therapy are crucial for favorable outcomes.
How to cite this article: Alkheder KA, Al‑Nahhas OF, Al‑Khafaji YB, Alssabagh AA, Thiyyagura SR. A rare case of purulent pericarditis arising from a hepato‑pericardial fistula. Turk J Emerg Med 2026;26:75-7.
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KA: Conceptualization (lead); writing – original draft (lead); formal analysis (lead); writing – review and editing (equal). YB: Analysis (equal); writing – review and editing (equal). OA: Analysis (equal); writing – review and editing (equal). AA: Analysis (equal); writing – review and editing (equal). EB: Supervision (Lead); writing – review and editing (equal).
None Declared.
None.