Magishi Katsuaki, Izumi Yuichi, Shimizu Noriyuki
Department of Cardiovascular Surgery, Nayoro City General Hospital, Nayoro, Japan.
Kyobu Geka. 2014 Jun;67(6):463-6.
A 48-year-old woman experienced a high fever and precordial pain. Computed tomography revealed pericardial fluid, and she was diagnosed with viral pericarditis. The pericardial fluid gradually increased, and she experienced pre-shock. Pericardial drainage was therefore performed, and the fluid was found to be purulent on the 11th day. Pleural effusion and ascites retention, then increased, and she was diagnosed with constrictive pericarditis on the 21st day by the date of the right ventricular pressure. Excision of the pericardium was performed through median sternotomy on the 27th day after the onset. As the ventricular diastolic function improved, the heart swelled, and sternal closure became impossible. It was finally closed 5 days after the surgery. The patient had no recurring infection, and was discharged on the 36th postoperative day. Although purulent pericarditis is a rare disease, you should keep in mind that it may progress rapidly to constrictive pericarditis.
一名48岁女性出现高热和心前区疼痛。计算机断层扫描显示心包积液，她被诊断为病毒性心包炎。心包积液逐渐增加，她出现了休克前期。因此进行了心包引流，在第11天时发现积液为脓性。随后胸腔积液和腹水潴留增加，在第21天时根据右心室压力诊断为缩窄性心包炎。发病后第27天通过正中胸骨切开术进行了心包切除术。随着心室舒张功能改善，心脏肿胀，无法关闭胸骨。最终在手术后5天关闭。患者没有反复感染，术后第36天出院。虽然脓性心包炎是一种罕见疾病，但应记住它可能迅速进展为缩窄性心包炎。
