Question:

What is the estimated distance between the left atrium and the esophagus?
1. 5mm
2. 10mm
3. 15mm
4. 20mm
5. None of the above





Answer:

The correct answer for the question "What is the estimated distance between the left atrium and the esophagus?" is:

1. 5mm



Explanation
A.    5mm is the approximate distance between the tissues.  [Further degradation of tissue boundaries allow for communication with the adjacent left atrium, as the measured distance approximates 5mm.]

B.    10mm distance between the tissues is too great of a distance  [Distractor.  Incorrect]

C.    15mm is not correct. [Distractor.  Incorrect]

D.    20mm is incorrect. [Distractor.  Incorrect]

E.    The answer is listed and is 5mm. [Distractor.  Incorrect]



From the manuscript:
Pericardioesophageal Fistula Following Left Atrial Ablation Procedure
Radiology Case. 2014 Oct; 8(10):23-31


This article belongs to the Cardiac section.




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From the manuscript

Pericardioesophageal Fistula Following Left Atrial Ablation Procedure

Free full text article: Pericardioesophageal Fistula  Following Left Atrial Ablation Procedure

Abstract
We present a case of pericardioesophageal fistula formation in a 40 year old male who 23 days after undergoing a repeat ablation procedure for atrial fibrillation developed chest pressure, chills and diaphoresis. After initial labs and tests that demonstrated no evidence for acute myocardial ischemia, the patient underwent CT angiography of the chest. The study revealed pneumopericardium and a pericardial effusion. Suspicion was raised of perforation of the posterior left atrial myocardial wall with injury to adjacent esophagus. Water soluble contrast with transition to barium sulfate esophagram subsequently performed identified a perforation further affirming the postulate of a fistulous communication between the esophagus and pericardium. Transthoracic echocardiogram confirmed pericardial effusion but did not demonstrate myocardial defect. Endoscopic management was preferred and an esophageal stent was placed. Follow up esophagram showed an intact esophageal stent without evidence of extravasation.






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