Case report of simultaneous presentation of pulmonary embolism and pericardial effusion following an oncological esophagectomy.

Introduction: This is the first reported case of simultaneous presentation of pulmonary embolism and pericardial effusion following esophagectomy. This case illustrates a diagnostic and therapeutic challenge exemplifying the difficulties arising from complex anticoagulant considerations in esophageal cancer.
Patient Case: A 72 year old male undergoes an oncological esophageal resection. Postoperatively the patient develops pulmonary embolism for which he is treated with Rivaroxaban. After starting Rivaroxaban the patient develops a large pericardial effusion.
Discussion: We suspect that the treatment of pulmonary embolism with Rivaroxaban had a causative role in the development of pericardial effusion. Based on literature we suspect that chemoradiotherapy increased susceptibility.
Conclusion: Diagnosis and treatment of simultaneous pulmonary embolism and pericardial effusion remains a challenge. Special consideration should be taken when using Rivaroxaban in esophageal cancer patients; this should always be conducted in consultation with a coagulation specialist.
(Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)