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Delayed pericardial effusion and cardiac tamponade following penetrating chest trauma

Published online by Cambridge University Press:  04 March 2015

Laura Donahoe ,
Maral Ouzounian ,
Scott MacDonald  and
Simon Field
Laura Donahoe*
Affiliation:
Division of General Surgery, Dalhousie University, Halifax, NS
Maral Ouzounian
Affiliation:
Division of Cardiac Surgery, Dalhousie University, Halifax, NS
Scott MacDonald
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS
Simon Field
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS
*
Dalhousie University, Division of General Surgery, QEII Health Sciences Centre, 1276 South Park Street, Halifax, NS B3H 2Y9; Laura.Donahoe@Dal.ca

Abstract

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We present the case of a 20-year-old man who was stabbed in the left chest and was diagnosed with a large pericardial effusion by focused emergency department (ED) ultrasonography. After placement of a left chest tube for presumed tension pneumothorax, the pericardial effusion had resolved. The patient's postinjury course was complicated by pericarditis and recurrent tamponade, which required repeated pericardiocentesis for management. This case illustrates the role of focused ED ultrasonography for diagnosis of pericardial effusion in penetrating trauma and the potential for delayed pericardial effusion and tamponade in such patients. Although the pathophysiology of delayed pericardial effusion is unclear, autoimmune postpericardiotomy syndrome has been proposed as the cause of this rare condition. Our case underscores the importance of close monitoring of patients with known or suspected pericardial injuries due to their potential for the development of lifethreatening complications.

Keywords

delayed tamponadefocused emergency department ultrasonographystab wound
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 3 , May 2013 , pp. 187 - 190
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

References

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