Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T08:01:46.944Z Has data issue: false hasContentIssue false
  • English
  • Français

Delayed pericardial effusion and cardiac tamponade following penetrating chest trauma

Published online by Cambridge University Press:  04 March 2015

Laura Donahoe ,
Maral Ouzounian ,
Scott MacDonald  and
Simon Field
Laura Donahoe*
Affiliation:
Division of General Surgery, Dalhousie University, Halifax, NS
Maral Ouzounian
Affiliation:
Division of Cardiac Surgery, Dalhousie University, Halifax, NS
Scott MacDonald
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS
Simon Field
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS
*
Dalhousie University, Division of General Surgery, QEII Health Sciences Centre, 1276 South Park Street, Halifax, NS B3H 2Y9; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

We present the case of a 20-year-old man who was stabbed in the left chest and was diagnosed with a large pericardial effusion by focused emergency department (ED) ultrasonography. After placement of a left chest tube for presumed tension pneumothorax, the pericardial effusion had resolved. The patient's postinjury course was complicated by pericarditis and recurrent tamponade, which required repeated pericardiocentesis for management. This case illustrates the role of focused ED ultrasonography for diagnosis of pericardial effusion in penetrating trauma and the potential for delayed pericardial effusion and tamponade in such patients. Although the pathophysiology of delayed pericardial effusion is unclear, autoimmune postpericardiotomy syndrome has been proposed as the cause of this rare condition. Our case underscores the importance of close monitoring of patients with known or suspected pericardial injuries due to their potential for the development of lifethreatening complications.

Keywords

delayed tamponadefocused emergency department ultrasonographystab wound
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 3 , May 2013 , pp. 187 - 190
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

References

REFERENCES

1.Hensell, MG. Review of blunt and penetrating trauma of heart and greater vessels. Top Emerg Med 2001;23:20–5.Google Scholar
2.Aaland, MO, Sherman, RT. Delayed pericardial tamponade in penetrating chest trauma: case report. J Trauma 1991;31: 1563–5, doi:10.1097/00005373-199111000-00022.CrossRefGoogle ScholarPubMed
3.Boulanger, BR, Kearney, PA, Tsuei, B, et al. The routine use of sonography in penetrating torso injury is beneficial. J Trauma Injury Infect Crit Care 2001;51:320–5, doi:10.1097/00005373-200108000-00015.Google Scholar
4.Horton, P, Slovis, CM. Spontaneous drainage of cardiactamponade. Ann Emerg Med 1983;12:96–8, doi:10.1016/S0196-0644(83)80382-5.Google Scholar
5.Harris, DG, Janson, JT, Van Wyk, J, et al. Delayed pericardial effusion following stab wounds to the chest. Eur J Cardiothorac Surg 2003;23:473–6, doi:10.1016/S1010-7940(03)00006-X.CrossRefGoogle ScholarPubMed
6.Bozinovski, J, Wang, S, Nakai, S. Delayed cardiac tamponade after coronary artery laceration. Ann Thorac Surg 2002;73:1314–5, doi:10.1016/S0003-4975(01)03191-5.CrossRefGoogle ScholarPubMed
7.Bellanger, D, Nikas, DJ, Freeman, JE, et al. Delayed posttraumatic tamponade. South Med J 1996;89:1197–9, doi:10.1097/00007611-199612000-00013.Google Scholar
8.Mechem, CC, Alam, G. Delayed cardiac tamponade in a patient with penetrating chest trauma. J Emerg Med 1997;15:31–3, doi:10.1016/S0736-4679(96)00240-5.CrossRefGoogle Scholar
9.Enriquez, SG, Fernandez, CG, Entem, FR, et al. Delayed pericardial tamponade after penetrating chest trauma. Eur J Emerg Med 2005;12:86–8, doi:10.1097/00063110-200504000-00008.Google Scholar
10.Karmy-Jones, R, Yen, T, Cornejo, C. Pericarditis after trauma resulting in delayed cardiac tamponade. Ann Thorac Surg 2002;74:239–41, doi:10.1016/S0003-4975(02)03477-X.CrossRefGoogle ScholarPubMed
11.Nijjer, SS, Dubrey, SW, Dreyfus, GD, et al. Delayed pericardial effusions: life-threatening complication presenting up to 100 days after chest trauma. Clin Med 2010;10:88–90.CrossRefGoogle ScholarPubMed