Delayed pericardial effusion following stab wounds to the chest

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dc.contributor.authorHarris D.G.
dc.contributor.authorJanson J.T.
dc.contributor.authorVan Wyk J.
dc.contributor.authorPretorius J.
dc.contributor.authorRossouw G.J.
dc.date.accessioned2011-05-15T16:16:19Z
dc.date.available2011-05-15T16:16:19Z
dc.date.issued2003
dc.description.abstractIntroduction: Delayed pericardial effusion following penetrating cardiac trauma has not been commonly reported, and the exact incidence remains unknown. It was more common before 1960, when pericardiocentesis was still a popular treatment for stable patients presenting with a stab wound to the heart. Material and methods: During an 8-year period, 24 patients were diagnosed with delayed pericardial effusions following a recent stab wound over the chest. Nine patients had been initially treated at our trauma unit, and the remaining 15 patients were referred by a peripheral clinic. Results: Diagnosis was confirmed by cardiac ultrasound or echocardiogram. Sixteen patients were adequately treated by subxiphoid drainage. Sternotomy was performed in five patients, left thoracotomy in two and right thoracotomy in one patient. No actively bleeding injuries were found. Three patients had active infection in the pericardial space. Fever, pleural effusions and ascites were common associated findings. Additional procedures performed included laparotomy for acute abdominal pain in two patients (both negative), and simultaneous drainage of a pleural empyema. Two patients with staphylococcal pericardial infections required subsequent pericardiectomy. Summary: The diagnosis of a penetrating cardiac patient may be missed in a stable patient, and patients may present with delayed pericardial effusions and tamponade. Post pericardiotomy syndrome may be the most common cause of delayed pericardial effusion, followed by sepsis. Subxiphoid pericardial window is an adequate form of treatment. Recent literature reveals that occult cardiac injury is not uncommon, thus a case should be made to actively investigate all patients with precordial stab wounds with cardiac ultrasound or echocardiogram. © 2003 Elsevier Science B.V. All rights reserved.
dc.description.versionArticle
dc.identifier.citationEuropean Journal of Cardio-thoracic Surgery
dc.identifier.citation23
dc.identifier.citation4
dc.identifier.issn10107940
dc.identifier.other10.1016/S1010-7940(03)00006-X
dc.identifier.urihttp://hdl.handle.net/10019.1/13727
dc.subjectabdominal pain
dc.subjectadolescent
dc.subjectadult
dc.subjectarticle
dc.subjectascites
dc.subjectclinical article
dc.subjectcontrolled study
dc.subjectechocardiography
dc.subjectfemale
dc.subjectheart injury
dc.subjecthuman
dc.subjectlaparotomy
dc.subjectmale
dc.subjectmorbidity
dc.subjectpericardial effusion
dc.subjectpericardiotomy
dc.subjectpleura effusion
dc.subjectpleura empyema
dc.subjectpriority journal
dc.subjectstab wound
dc.subjectStaphylococcus infection
dc.subjectsternotomy
dc.subjectthoracotomy
dc.subjectthorax
dc.subjectthorax drainage
dc.subjectAdolescent
dc.subjectAdult
dc.subjectDrainage
dc.subjectFemale
dc.subjectHeart Injuries
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPericardial Effusion
dc.subjectPericarditis
dc.subjectStaphylococcal Infections
dc.subjectTime Factors
dc.subjectWounds, Stab
dc.titleDelayed pericardial effusion following stab wounds to the chest
dc.typeArticle
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