Whiley Phillip J, Rodrigues Nicole, Balasooriya Janaka
The Australian National University Medical School, The Canberra Hospital, Canberra, ACT, Australia.
General Surgery Division, The Canberra Hospital, Canberra, ACT, Australia.
J Surg Case Rep. 2022 Feb 6;2022(2):rjac009. doi: 10.1093/jscr/rjac009. eCollection 2022 Feb.
Pericardiocentesis is a generally safe procedure that provides effective resolution of cardiac tamponade. Emergency pericardiocentesis may be a life-saving intervention. Encountering an intra-abdominal organ in the path of the needle is predicted to be a potential complication in emergency subxiphoid approaches. Despite predictions of intraabdominal injuries, only few instances are recorded. In this case study, a patient recovering from percutaneous cardiac intervention required an emergency pericardiocentesis that was complicated by a liver injury, diaphragmatic penetration and pneumo-haemoperitoneum requiring surgical intervention to remove the drain. The case discusses options for performing the procedure, patient factors that can complicate the procedure and radiological and surgical diagnosis and treatment of this rare event.
心包穿刺术是一种总体安全的操作,可有效解除心脏压塞。急诊心包穿刺术可能是一种挽救生命的干预措施。预计在急诊剑突下穿刺途径中,针道遇到腹腔内器官是一种潜在并发症。尽管有腹腔内损伤的预测,但记录在案的病例却很少。在本病例研究中,一名正在从经皮心脏介入治疗中恢复的患者需要进行急诊心包穿刺术,该操作并发肝损伤、膈肌穿透和气腹-血腹,需要手术干预以取出引流管。该病例讨论了进行该操作的选择、可能使操作复杂化的患者因素以及这种罕见事件的放射学和外科诊断与治疗。