A Rare Case Oesophageal Perforation by a Fish Bone, Leading to Pericardial Penetration and Cardiac Tamponade

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An 82-year-old woman swallowed a fish bone and presented to our hospital 3 days later when she had breathing difficulty and became hypotensive. Chest computed tomography (CT) showed a linear structure with high bone density extending from the oesophagus into the pericardium, along with pericardial effusion, air, and a left pleural effusion. We diagnosed the patient with oesophageal perforation by a foreign body (a fish bone) leading to pericardial penetration, cardiac tamponade, and left empyema. The patient underwent emergency surgery. Pericardial fenestration and drainage of the pericardial and thoracic cavities were performed. Chest CT showed a recurrent abscess cavity in the pericardium on day 6. A pigtail catheter was placed in the recurrent abscess cavity under CT guidance for drainage. The patient gradually improved and was discharged after 5 months.