Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Ann Thorac Surg. 2010 Jun;89(6):2028-30. doi: 10.1016/j.athoracsur.2009.10.048.
If undiagnosed, traumatic pericardial rupture with herniation of the heart may have fatal consequences. We report two cases of multiple trauma with pericardial rupture, which was missed in the preoperative diagnoses of both patients, in spite of suggestive signs on computed tomographic scans. One patient had unexplained, persistent hemodynamic instability; the second patient had cardiac arrest during laparotomy for minor hepatic laceration. In both, the left-sided rupture of the pericardium with cardiac herniation into the pleural space was found and corrected in an emergency intervention. Both patients recovered completely.
如果未能诊断出创伤性心包破裂伴心脏疝出，可能会导致致命后果。我们报告了两例多发创伤性心包破裂的病例，尽管计算机断层扫描有提示性征象，但这两例患者在术前诊断中均被漏诊。一例患者出现不明原因的持续性血流动力学不稳定；另一例患者在因小肝裂伤行剖腹手术时发生心脏骤停。在这两例患者中，均发现左侧心包破裂，心脏疝入胸腔，并在紧急介入治疗中得到纠正。两例患者均完全康复。
