Yu Peter S Y, Ng Vikki W K, Lau Rainbow W H, Ng Calvin S H
Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
J Thorac Dis. 2018 Jan;10(1):E27-E30. doi: 10.21037/jtd.2017.11.131.
A 11-year-old boy presented with refractory fever and dyspnoea after Nuss procedure. Massive pericardial effusion was detected on computer tomography scan performed under corticosteroid cover for his asthmatic history. With rapid clinical improvement following corticosteroids, a clinical diagnosis of post-pericardiotomy syndrome (PPS) was made. Following a course of oral prednisolone, serial blood test and echocardiogram showed gradual resolution of inflammation and pericardial effusion. This rarely-reported case serves as a poignant reminder to PPS after Nuss procedure as a cause of febrile massive pericardial effusion. Early therapeutic trial of corticosteroids may prevent clinical deterioration, and have invasive pericardial drainage avoided.
一名11岁男孩在努氏手术后出现难治性发热和呼吸困难。因有哮喘病史，在给予皮质类固醇治疗的情况下进行计算机断层扫描，发现大量心包积液。使用皮质类固醇后临床症状迅速改善，临床诊断为心包切开术后综合征（PPS）。经过一个疗程的口服泼尼松龙治疗，系列血液检查和超声心动图显示炎症和心包积液逐渐消退。这一罕见病例强烈提醒人们，努氏手术后的PPS是发热性大量心包积液的一个原因。早期进行皮质类固醇治疗试验可防止临床病情恶化，并避免进行有创心包引流。
