Late Cardiac Tamponade in a Patient Victim of Penetrating Trauma – Case Report

Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit clinical management, with hospital discharge in the 7th postoperative day.

病例报告摘要：报告1例49岁男性刺伤患者，其伤后迟发性出现心脏压塞（cardiac tamponade），就诊时血流动力学稳定。该患者接受心包开窗术（pericardial window），引流出外观呈黑色的心包积液（pericardial effusion）；但术中未探明心脏损伤病灶，遂改行正中胸骨切开术（median sternotomy）扩大手术切口。术中于左心室处发现血肿伴心外膜损伤（epicardial lesion），遂采用3-0聚丙烯制作心包补片完成修补。患者术后并发急性肺水肿（acute pulmonary edema）与心房颤动（atrial fibrillation），经重症监护病房（intensive care unit, ICU）临床处置后病情好转，于术后第7日出院。