Atriocaval laceration presenting as delayed pericardial tamponade

Moore, Forrest O.; Berne, John D.; Fulda, Gerard J.; Fox, Adam D.; Tinkoff, Glen; Davies, Allen L.; McNicholas, Kathleen W.

doi:10.1016/j.jtcvs.2006.03.022

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…Although traumatic cardiac problems usually occur immediately during the acute phase, cases have been reported where mild myocardial injury and sternum fracture caused delayed cardiac tamponade [6,7]. Late-onset cardiac injury resulting from a rib stump, as we reported, may be rare.…”

Section: Discussionmentioning

confidence: 68%

Cardiac injury due to the rapid progress of the dislocation of rib fractures: A rare case that required urgent open reduction and internal rib fixation

Okamoto

Ueda

Ichinose

2019

Respiratory Medicine Case Reports

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Background Most rib fractures are treated conservatively, but patients with severe trauma may require surgical treatment. We report a rare case of delayed pericardial injury due to a fractured rib stump. Case presentation A 61-year-old man fell while riding a bicycle and was transferred to our hospital. A computed tomography (CT) scan showed mild rib fractures on the 4th-6th ribs, and he was hospitalized because of acute pain. A few days later, his respiratory condition had worsened. CT showed that the rib fractures progressed significantly, and the stump was in contact with the heart, so we performed an urgent surgical rib fixation. Operative findings revealed intrathoracic hemorrhage by the pericardial laceration because of the rib stump. The 4th-7th ribs were internally fixed using a screwless titanium metal plate, and he was discharged without complications on the 20th postoperative day. Conclusion We experienced a rare case of pericardial injury caused by a rapid dislocation of rib fractures. Urgent surgical treatment was able to prevent a serious complication.

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Section: Discussionmentioning

confidence: 68%

Cardiac injury due to the rapid progress of the dislocation of rib fractures: A rare case that required urgent open reduction and internal rib fixation

Okamoto

Ueda

Ichinose

2019

Respiratory Medicine Case Reports

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“…Delayed cardiac tamponade is a well-described entity after both blunt [ 3 ] and penetrating trauma [ 1 ]. Pericardial effusion can be seen late in up to 22% of penetrating chest injuries [ 4 ] but luckily only a small fraction of these will present in clinical tamponade.…”

Section: Discussionmentioning

confidence: 99%

“…A diagnostic and therapeutic challenge: delayed cardiac tamponade can occur up to 100 days after the index injury, and it may have an atypical presentation [ 5 ]. The etiology of the late presentation is unclear, although several mechanisms have been proposed including clot sealing a partial tear that either allows a slow leak into the pericardial sac or suddenly dislodges leading to more rapid accumulation [ 3 ]; autoimmune pericarditis and subsequent pericardial effusion; and unidentified laceration of a coronary artery with subsequent spasm that later hemorrhages [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

Almehmadi

Chandy

Connelly

et al. 2016

Case Reports in Cardiology

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Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse. The pericardial effusion was treated with emergent pericardiocentesis and later required a thoracoscopy guided pericardial window for definitive management.

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“…Cardiac tamponade is the most common presentation of atrial rupture with a clinical evolution less rapid than left ventricular or thoracic aortic rupture [10,11]. The preferential sites of right atrial lesions are the appendages (vulnerable thin walls), free wall, and superior vena cava-right atrium junction [12,13] (Table 1). …”

Section: Discussionmentioning

confidence: 99%

Right atrial free wall rupture after blunt chest trauma

Maria

Gaddi

Navazio

et al. 2007

Journal of Cardiovascular Medicine

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We report the case of an 18-year-old man, victim of a car accident, presenting with severe hypotension and signs of cardiac tamponade. Transoesophageal echocardiography was suggestive of right atrial free wall rupture. The patient underwent urgent cardiac surgery for repair of right atrial rupture. The immediate clinical outcome was favourable; the patient is in good general condition at 24-month follow-up. The right atrium is rarely involved in cardiac contusion as compared to the right ventricle or other cardiac structures, owing to its anatomical location and direction of physical forces.

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Atriocaval laceration presenting as delayed pericardial tamponade

Cited by 5 publications

References 4 publications

Cardiac injury due to the rapid progress of the dislocation of rib fractures: A rare case that required urgent open reduction and internal rib fixation

Cardiac injury due to the rapid progress of the dislocation of rib fractures: A rare case that required urgent open reduction and internal rib fixation

Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

Right atrial free wall rupture after blunt chest trauma

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