title: Traumatic pericardial rupture without cardiac injury.
abstract: Pericardial rupture is a rare injury following blunt chest trauma. It is frequently fatal because of serious complications such as cardiac herniation and/or contusion. We report a case of traumatic pericardial rupture without cardiac injury, which was incidentally identified intraoperatively. A 63-year-old woman was transported to the hospital after sustaining blunt chest trauma from a motor vehicle accident. Radiographic workup demonstrated multiple fractures, pulmonary contusion, and hemopneumothorax. A chest tube was inserted, and persistent bleeding was observed. An exploratory thoracotomy was performed, and active pulmonary bleeding was controlled. Further exploration revealed major pericardial rupture without cardiac herniation or intrapericardial injury, which was repaired by a bovine pericardial patch. Her postoperative course was uneventful. It is usually difficult to make a diagnosis of pericardial rupture, and a misdiagnosis often leads to a fatal consequence. Therefore, an immediate surgical exploration is warranted if clinical and radiographic findings suggest the condition.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin, School of Medicine, 1300 University Avenue, Madison, WI 53706, USA. teruyan@kure-nh.go.jp
authors.forename: Teruya
authors.initials: T
authors.lastname: Nakamura
authors.forename: James D
authors.initials: JD
authors.lastname: Maloney
authors.forename: Satoru
authors.initials: S
authors.lastname: Osaki
mesh_terms: D000063:Accidents, Traffic; D000818:Animals; D006348:Cardiac Surgical Procedures; D002417:Cattle; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000293:injuries* / Q000637:transplantation; D013898:Thoracic Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome