[Early diagnosis of traumatic extra-pericardial luxation of the heart. Value of tomodensitometry. Apropos of a case].
Heart luxation is a rare complication of chest trauma. The rupture of pericardium must be diagnosed as soon as possible, particularly before prolonged orthopaedic surgery for multitrauma, as a cardiac arrest may occur during anaesthesia. This report underlines the difficulties of diagnosis in a 40-year-old patient with head trauma, chest trauma and multiple fractures. The diagnosis was suspected on unstable blood pressure and left lung atelectasis. The computed tomography showed herniation of the left ventricle. Emergency thoracotomy showed the left rupture of pericardium with complete left heart dislocation. Orthopaedic operation was carried out three days later. Computed tomography in multitrauma patients, seems to be decisive for early diagnosis of heart luxation. Emergency thoracotomy is essential.
Deslandes
V
V
Département d'Anesthésiologie, Centre Hospitalier Universitaire, Angers.
Jacob
J P
JP
Chapillon
M
M
L'Hoste
P
P
de Brux
J L
JL
Delhumeau
A
A
D000328:Adult; D006335:Heart Injuries / Q000175:diagnosis* / Q000601:surgery; D006547:Hernia / Q000175:diagnosis* / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000150:complications*; D010496:Pericardium / Q000293:injuries; D013898:Thoracic Injuries / Q000150:complications; D014057:Tomography, X-Ray Computed
Diagnostic précoce de la luxation extrapéricardique du coeur d'origine traumatique. Intérêt de la tomodensitométrie. A propos d'un cas.