Tension pneumopericardium in blunt thoracic trauma
| Autor: | Elcio S. Hirano, Antonio Fernando Rolim Marques, Lizianne Hermogenes Lopes, Cesar Vanderlei Carmona, Gustavo Pereira Fraga, Marcela dos Santos Martins |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
BP blood pressure medicine.medical_specialty UDE Upper Digestive Endoscopy Case Report Tension pneumopericardium Blunt thoracic trauma Pneumopericardium 030204 cardiovascular system & hematology BPM beats per minute FAST Focused Assessment with Sonography for Trauma 03 medical and health sciences 0302 clinical medicine Blunt ICU Intensive Care Unit Cardiac tamponade Macklin effect medicine Focused assessment with sonography for trauma 030212 general & internal medicine Thoracic trauma business.industry Shock medicine.disease Surgery Pericardial sac PO post-operative day Shock (circulatory) Anesthesia medicine.symptom business Hemodynamic instability |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2016.04.052 |
| Popis: | Highlights • Tension pneumopericardium is a cause of shock in thoracic trauma. • It should be regarded in hemodynamically unstable patients with blunt chest trauma. • Immediate pericardium decompression may save the patient’s life. Introduction Pneumopericardium, defined as the presence of gas in the pericardial sac, is a rare condition caused mostly by trauma. Tension pneumopericardium is a cause of hemodynamic instability; hence, it consists in a life-threatening situation and should be regarded in blunt chest trauma. Case report A 51-year-old male was victim of a 4 m fall and burial. He was stable upon admission and presented a simple pneumopericardium and pneumomediastinum on CT. While being submitted to an upper digestive endoscopy he presented respiratory failure and had to be intubated, suddenly evolving to shock. He was promptly referred to the operating room; a pericardial window confirmed tension pneumopericardium and immediately hemodynamic stability was restored. A pericardial drain was placed and kept for 15 days. He was discharged at the 18th day post-trauma after a satisfactory recovery at the trauma ICU. Discussion Blunt thoracic trauma causes pneumopericardium by various mechanisms. Tension pneumopericardium is a possible outcome, probably related to positive-pressure ventilation. It leads to hemodynamic instability and requires immediate decompression and placement of a pericardial drain. |
| Databáze: | OpenAIRE |
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