Colo-pericardial fistula: complication of colonic interposition.

This report discusses a unique and previously unreported complication of a colonic interposition following esophageal replacement. A 7-year-old boy under-went a right colonic interposition following extensive esophageal lye burn. Fifteen years post-colonic interposition, the 22-year-old man was admitted to an adult medical ward with chest pain, cardiomegaly, and fever. Barium swallow revealed a colo-pericardial fistula with massive pericarditis. The patient survived an immediate thoracotomy with the removal of the colon and a pericardiectomy. Several months later the patient underwent a successful left colonic interposition. This case illustrates that immediate and aggressive surgical therapy may prevent an otherwise fatal outcome.