An uncommon potentially lethal injury: Traumatic pericardial rupture with herniation of the heart

Abstract

Traumatic rupture of the pericardium with herniation of the heart can be a potentially lethal injury that can be easily overlooked. Prompt diagnosis and repair can be lifesaving. We report such a case with successful repair of this injury in a 45-year-old male who sustained multiple injuries following a motor vehicle accident. CT scan revealed rupture of the pericardium with herniation of the heart. The pericardial tear was promptly repaired by primary closure. This report gives an insight into this life threatening, yet promptly treatable condition, which can be easily missed resulting in a fatal outcome. Having a high index of suspicion while treating thoracic trauma patients can prevent fatalities. Immediate referral to a cardiothoracic service or closure of the tear through a thoracotomy, if the expertise is available, can be lifesaving.