Diagnosis and management of pericardial abscess in trauma patients

Thomas T. Sato, Randolph L. Geary, David G. Ashbaugh, Gregory Jurkovich

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)637-641
Number of pages5
JournalThe American Journal of Surgery
Volume165
Issue number5
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

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Abscess
Wounds and Injuries
Pericarditis
Multiple Organ Failure
Drainage
Sepsis
Pericardiocentesis
Pericardiectomy
Torso
Systemic Inflammatory Response Syndrome
Thoracotomy
Intensive Care Units
Tomography
Inflammation
Survival
Infection

ASJC Scopus subject areas

  • Surgery

Cite this

Diagnosis and management of pericardial abscess in trauma patients. / Sato, Thomas T.; Geary, Randolph L.; Ashbaugh, David G.; Jurkovich, Gregory.

In: The American Journal of Surgery, Vol. 165, No. 5, 01.01.1993, p. 637-641.

Research output: Contribution to journalArticle

Sato, Thomas T. ; Geary, Randolph L. ; Ashbaugh, David G. ; Jurkovich, Gregory. / Diagnosis and management of pericardial abscess in trauma patients. In: The American Journal of Surgery. 1993 ; Vol. 165, No. 5. pp. 637-641.
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