Pneumopericardium and esophagopericardial fistula presenting as pericarditis in a 1-year-old boy.

Esophagopericardial fistula (EPF) is an uncommon complication of esophageal disease. Although, the esophagus is in direct contact with the pericardium in the lower thoracic vertebrae level, EPF is still rare. Recorded causes of EPF include ingested foreign bodies such as fish bone, benign ulceration in association with hiatus hernia, esophageal carcinoma, and achalasia. Congenital EPF occurs even less but with a high ratio of mortality and misdiagnosis. We present a case of PEF in a 1-year-old boy. It is unique in that the patient was a very young child which is rarely reported in literature and the main cause factor seemed to be repeated vomiting since birth. However, he had a good outcome with surgical treatment.