Polymicrobial bacterial pericarditis and cardiac tamponade caused by pericardial penetration of an adjustable gastric band

BMJ Case Rep. 2018 Feb 16:2018:bcr2017221589. doi: 10.1136/bcr-2017-221589.

Abstract

We describe a case of polymicrobial bacterial pericarditis with Klebsiella pneumoniae and Proteus mirabilis, caused by pericardial penetration of the tip of the catheter of a laparoscopic adjustable gastric band (LAGB). The patient developed a cardiac tamponade, and subsequently emergency pericardiocentesis was performed. Analysis of earlier CT scans showed that the tip of the catheter had migrated through the liver and through the diaphragm into the pericardium, and was in contact with the myocardium. After stabilisation he was operated to remove the LAGB. In this case report, we describe the chain of events that led to the polymicrobial pericarditis-a complication of LAGB placement that to our knowledge has thus far never been reported. We furthermore present a detailed literature review of all published cases of polymicrobial pericarditis and its causes.

Keywords: emergency medicine; gastroenterology; gastrointestinal surgery; interventional cardiology.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cardiac Tamponade / diagnosis
  • Cardiac Tamponade / etiology*
  • Cardiac Tamponade / therapy
  • Catheters / adverse effects*
  • Computed Tomography Angiography
  • Foreign-Body Migration / diagnostic imaging*
  • Gastric Bypass / adverse effects*
  • Humans
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / etiology
  • Klebsiella Infections / therapy
  • Klebsiella pneumoniae / isolation & purification
  • Liver / diagnostic imaging
  • Male
  • Middle Aged
  • Pericardiocentesis
  • Pericarditis / diagnosis
  • Pericarditis / etiology*
  • Pericarditis / therapy
  • Pericardium / injuries*
  • Proteus Infections / diagnosis
  • Proteus Infections / etiology
  • Proteus Infections / therapy
  • Proteus mirabilis / isolation & purification
  • Treatment Outcome