Khalpey Zain, Rajab Taufiek K, Schmitto Jan D, Camp Philipp C
Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Cardiothorac Surg. 2011 Jan 17;6:6. doi: 10.1186/1749-8090-6-6.
Traumatic pericardial rupture is a rare presentation. Pericardial rupture itself is asymptomatic unless complicated by either hemorrhage or herniation of the heart through the defect. Following diagnosis surgical repair of the pericardium is indicated because cardiac herniation may result in vascular collapse and sudden death.
Here we present a case of traumatic, non-herniated pericardial rupture with complete skeletonization of the phrenic nerve.
An 18-year-old healthy male suffered multi-trauma after falling 50 feet onto concrete. The patient could not be stabilized despite exploratory laparotomy with splenectomy, IR embolization and packing for a liver laceration. Right posterolateral thoracotomy revealed a ruptured pericardium with a completely skeletonized phrenic nerve. The pericardium was repaired with a Goretex(R) patch.
A high level of suspicion for pericardial rupture is necessary in all patients with high-velocity thoracic injuries.
创伤性心包破裂是一种罕见的表现。心包破裂本身无症状，除非并发出血或心脏通过缺损处发生疝出。诊断后应进行心包手术修复，因为心脏疝出可能导致血管塌陷和猝死。
在此，我们报告一例创伤性、非疝出性心包破裂伴膈神经完全骨骼化的病例。
一名18岁健康男性从50英尺高处坠落到混凝土上后遭受多处创伤。尽管进行了剖腹探查脾切除术、介入放射栓塞术以及对肝裂伤进行了填塞处理，但患者病情仍无法稳定。右后外侧开胸手术显示心包破裂，膈神经完全骨骼化。心包用戈尔特斯（Goretex）补片修复。
对于所有高速胸部损伤患者，都必须高度怀疑心包破裂。
