Revista Portuguesa de Pneumologia Revista Portuguesa de Pneumologia
Rev Port Pneumol 2017;23:156-9 - Vol. 23 Num.3 DOI: 10.1016/j.rppnen.2017.01.005
Case report
Esophagopericardial fistula, septic shock and intracranial hemorrhage with hydrocephalus after lung transplantation
M.M. Schuurmansa,, , C. Bendena, C. Moehrlenb, C. Gublerc, M. Wilhelmd, W. Wedere, I. Incie
a University Hospital Zurich, Pulmonology, Zurich, Switzerland
b University Hospital Zurich, Anaesthesiology, Zurich, Switzerland
c University Hospital Zurich, Gastroenterology, Zurich, Switzerland
d University Hospital Zurich, Cardiac Surgery, Zurich, Switzerland
e University Hospital Zurich; Thoracic Surgery, Zurich, Switzerland
Received 21 June 2016, Accepted 15 January 2017
Abstract

A 57-year old woman underwent lung transplantation for non-specific interstitial pneumonia. Primary graft dysfunction was diagnosed requiring continued use of extracorporeal membrane oxygenation (ECMO). Within three days she developed recurring hemothoraces requiring two surgical evacuations. After ECMO removal a series of complications occurred within four months: femoral thrombosis, persisting tachycardic atrial fibrillation, pneumopericardium with an esophagopericardial fistula and purulent pericarditis, septic shock, multiorgan failure and intracerebral hemorrhage with ventricular involvement requiring external ventricular drainage. Interdisciplinary management coordinated by the intensive care specialist, transplant surgeon and pulmonologist with various interventions by the respective specialists followed by intensive physical rehabilitation allowed for discharge home on day 235 post transplant. Subsequently quality of life was considered good by the patient and family.

Keywords
Lung transplantation, Esophagopericardial fistula, Intracranial hemorrhage, Complications, Treatment
Rev Port Pneumol 2017;23:156-9 - Vol. 23 Num.3 DOI: 10.1016/j.rppnen.2017.01.005