[Blunt trauma to the intrapericardial inferior vena cava with concomitant rupture of the pericardium].

We report a rare case of blunt trauma to the intrapericardial inferior vena cava with concomitant rupture of the pericardium, which was successfully managed by surgical treatment. A 77-year-old male was transferred to our hospital for treatment of trauma by a traffic accident. The patient presented with the sign of shock and there were no external injuries. After admission, right-sided traumatic hemothorax and left-sided traumatic pneumothorax were drained with chest tubes. Although an echocardiography and chest computed tomography (CT) demonstrated no pericardial fluid collection and cardiovascular injuries, his blood pressure dropped suddenly with massive hemorrhage from right thoracic cavity after starting continuous suction drainage of bilateral chest tubes. Thus, we decided to perform emergency operation, while assuming that cardiovascular injuries were the source of the bleeding. A right-sided thoracotomy revealed that a small laceration of intrapericardial inferior vena cava with the pericardial tear was the site of the bleeding. Repair for that injury was done with interrupted sutures without cardiopulmonary bypass. He recovered gradually, and moved to department of orthopaedic surgery in a stable condition on the 25th hospital day.