Smith D R
Department of Surgery, University of Alabama at Birmingham, USA.
Ala Med. 1995 Mar;64(9):6-8.
Pericarditis is a common clinical entity which has been reported frequently in association with numerous disease processes. However, pericarditis following blunt thoracic trauma is exceedingly rare and difficult to diagnosis. An 18 year-old female was transferred to UAB Hospital for evaluation and management of multiple injuries following a high-speed single-vehicle motor vehicle accident. Injuries included a fractured right tibia and femur, pelvic fracture, and a right pulmonary contusion with rib fractures. Orthopedic procedures were performed. Ventilatory support was provided due to a severe pulmonary contusion. The post-operative course was unremarkable. The patient was discharged two weeks after admission. One week after discharge, the patient was readmitted with pleuritic chest pain of several days duration. Diagnostic studies were performed. The patient was successfully treated with non-steroidal anti-inflammatory medications for pericarditis. Dramatic improvement ensured over two days. Follow-up showed no recurrence of pericardial symptoms, pleural effusion, or chest pain. In retrospect, complaints of episodic chest pain which were felt to be clinically insignificant during admission, may have been early signs of posttraumatic pericarditis secondary to blunt thoracic trauma.
心包炎是一种常见的临床病症，常与多种疾病过程相关报道。然而，钝性胸部创伤后的心包炎极为罕见且难以诊断。一名18岁女性在高速单车车祸后因多处受伤被转至UAB医院进行评估和治疗。损伤包括右胫骨和股骨骨折、骨盆骨折以及伴有肋骨骨折的右肺挫伤。进行了骨科手术。因严重肺挫伤给予通气支持。术后过程平稳。患者入院两周后出院。出院一周后，患者因持续数天的胸膜炎性胸痛再次入院。进行了诊断性检查。患者因心包炎成功接受非甾体类抗炎药物治疗。两天内病情显著改善。随访显示心包症状、胸腔积液或胸痛均无复发。回顾来看，入院期间被认为临床意义不大的发作性胸痛主诉，可能是钝性胸部创伤继发创伤后心包炎的早期迹象。
