{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T12:46:43Z","timestamp":1775047603801,"version":"3.50.1"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T00:00:00Z","timestamp":1672704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2023,3]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Pneumopericardium is a dreaded complication in esophageal carcinoma.<\/jats:p><\/jats:sec>Case description<\/jats:title>We report a case of a 62 year old patient with past history of esophageal cancer with pneumopericardium, without hemodynamic compromise. Admission echocardiogram that revealed a pneumopericadium with the presence of the \u201cswirling bubbles\u201d and the \u201cair gap\u201d sign. A small esophagopericardial fistula was postulated as the cause of the pneumopericardium. He underwent esophageal stent placement with almost complete resolution of the pneumopericardium.<\/jats:p><\/jats:sec>Discussion<\/jats:title>Pneumopericardium is usually a sign of marked clinical deterioration in neoplasia and leads to patients\u2019 death few weeks. Here we presented a case, in which a more fortunate and unusual outcome happened.<\/jats:p><\/jats:sec>Case description<\/jats:title>We present a case of a 62 year old patient, with a past history of esophageal cancer with pulmonary metastases undergoing palliative chemotherapy treatment and with two palliative esophageal stents. Other past medical history included active hepatitis B, arterial hypertension and dyslipidaemia. He was an ex smoker of 80 pack\u2010year units.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15511","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T06:44:16Z","timestamp":1672814656000},"page":"252-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The \u201cairgap\u201d and \u201cswirling bubbles\u201d signs in a patient with esophageal carcinoma"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5229-8190","authenticated-orcid":false,"given":"Tiago Castro","family":"Pinto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Hospital Pedro Hispano Matosinhos Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiago","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Pedro Hispano Matosinhos Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5299-9341","authenticated-orcid":false,"given":"Daniel","family":"Seabra","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Pedro Hispano Matosinhos Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Pedro Hispano Matosinhos Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,3]]},"reference":[{"key":"e_1_2_3_2_1","first-page":"66","volume-title":"Pyopneupericardium Attirubuted to an Esophagopericardial Fistula: Report of a Survivor and Review of the Literature","author":"Miller WL","year":"1991"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.50.6140"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12270"},{"key":"e_1_2_3_5_1","first-page":"24","article-title":"Pneumopericardium: a Rare Complication of Pericardiocentesis","author":"Iskander S","year":"2016","journal-title":"J Cardiovasc Ultrasound"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.13514"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytaa346"},{"key":"e_1_2_3_8_1","doi-asserted-by":"crossref","unstructured":"TakayamaT.Esophageal Cancer with an Esophagopericardial Fistula and Purulent Pericarditis.2013;52:2013.","DOI":"10.2169\/internalmedicine.52.8673"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2000.110084"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15511","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.15511","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T15:20:13Z","timestamp":1692631213000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.15511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,3]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/echo.15511"],"URL":"https:\/\/doi.org\/10.1111\/echo.15511","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,3]]},"assertion":[{"value":"2022-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}