Diagnosis and management of pericardial abscess in trauma patients. Am J Surg 1993 May;165(5):637-41
Date
05/01/1993Pubmed ID
8488952DOI
10.1016/s0002-9610(05)80451-9Scopus ID
2-s2.0-0027275043 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
Pericardial infection is an uncommon clinical entity after traumatic injury. Although invasive intervention is rarely necessary for mild pericardial inflammation, pericardial abscess can be life-threatening. The charts of 27 patients with pericarditis requiring management in the intensive care unit and/or invasive intervention at Harborview Medical Center during a 10-year period were reviewed. Six cases of trauma-related pericarditis were identified, including three cases of pericardial abscess following torso trauma without initial cardiac or pericardial injury. Pericardial abscess following trauma was associated with the sepsis syndrome and multiple system organ failure (MSOF) in all patients. Computed tomography and pericardiocentesis were useful diagnostic adjuncts. All patients required thoracotomy for pericardial drainage and pericardiectomy. Successful surgical management of pericardial abscess contributed to the resolution of sepsis, multiple end-organ dysfunction and, ultimately, patient survival in all cases. We conclude that pericardial abscess, although rare, should be considered a potential occult site of sepsis capable of driving MSOF in trauma patients. Expedient diagnosis and surgical drainage are essential for successful patient outcome.
Author List
Sato TT, Geary RL, Ashbaugh DG, Jurkovich GJMESH terms used to index this publication - Major topics in bold
AbscessAdult
Aged
Drainage
Echocardiography
Electrocardiography
Emergencies
Female
Humans
Male
Middle Aged
Multiple Organ Failure
Pericarditis
Retrospective Studies
Thoracotomy
Tomography, X-Ray Computed
Wounds, Nonpenetrating
Wounds, Penetrating
