# Case Report: Late presentation of post-coronary artery bypass surgery pericardial effusion heralding mediastinitis with tracheocutaneous fistula

## TL;DR

A rare case shows late pericardial effusion after heart surgery led to mediastinitis and a tracheocutaneous fistula.

## Contribution

First reported case linking pericardial tamponade with mediastinitis and tracheocutaneous fistula.

## Key findings

- Late pericardial effusion required pericardiocentesis and readmission.
- Mediastinitis was complicated by a tracheocutaneous fistula.
- This is the first reported case linking these post-surgery complications.

## Abstract

Post-coronary artery bypass surgery pericardial effusions are typically self-limiting but may rarely be significant, causing pericardial tamponade. We describe a case of late post-operative pericardial effusion that required pericardiocentesis and subsequent readmission for mediastinitis with the added complication of a tracheocutaneous fistula. Our case report is the first reported instance of pericardial tamponade heralding the onset of mediastinitis. It also describes the rare complication of tracheocutaneous fistula associated with mediastinitis.