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J Thorac Cardiovasc Surg 2002;123:367-368
© 2002 The American Association for Thoracic Surgery

Brief Communications

Heart herniation after blunt chest trauma

Guglielmo Maria Actis Dato, MDa, Anna Arslanian, MDb, Pier Luigi Filosso, MDb, Enrico Aidala, MDa, Mario Adduci, MDc, Gianluca Bardi, MDa, Enrico Ruffini, MDb Torino, Italy

From the Departments of Cardiac Surgery,a Thoracic Surgery,b and Emergency Surgery,c University of Torino, Torino, Italy.

Received for publication July 23, 2001. Accepted for publication Aug 2, 2001. Address for reprints: Enrico Ruffini, MD, Thoracic Surgery, University of Torino, 3, Via Genova 10126, Torino, Italy (E-mail: enrico.ruffini@unito.it).

Pericardial rupture after blunt chest trauma is a rare occurrence,Go 1 in most cases associated with other major injuries. Pericardial rupture may result in cardiac herniation with kinking of the great vessels, hypovolemic shock, and a mortality as high as 50% depending on the associated visceral and parietal injuries.

We present a case of heart herniation due to pericardial rupture after blunt chest trauma successfully managed with prompt surgical correction.

Clinical summary
A 68-year-old man was involved in an automobile accident and was transferred to the nearest local hospital. A chest radiograph showed sternal and multiple rib fractures. Examination of the left hemithorax revealed an anterior flail chest. About 1 hour after admission the patient required orotracheal intubation for acute respiratory insufficiency; systolic blood pressure dropped to 60 mm Hg and infusion therapy and inotropic support with dobutamine were started. Because of the . . . [Full Text of this Article]




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