Avtor/Urednik		Marinšek, Martin; Sinkovič, Andreja; Kanič, Vojko; Antonič, Jože
Naslov		Perikardialni izliv in tamponada srca po iatrogeni poškodbi osrčnika
Prevedeni naslov		Pericardial effusion and cardiac tamponade after iatrogenic trauma of the pericardium
Tip		članek
Vir		In: Bručan A, Gričar M, Fink A, et al, editors. Urgentna medicina: izbrana poglavja 7. Zbornik 8. mednarodni simpozij o urgentni medicini; 2001 jun 13-16; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2001
Obseg		str. 313-6
Jezik		slo
Abstrakt		Background. Pericardial effusion may be the consequence of different conditions, including inflammation and trauma of the pericardium. If the accumulated intrapericardial fluid results in cardiac compression, cardiac tamponade developes. This is an emergency situation and urgent pericardiocentesis is needed. Methods and results. We present a case of a 23 years old patient with dyspnea and chest pain due to abundant pericardial effusion, that developed several weeks after operative correction of congenital chest wall deformity and implantation of a metalic osteosinthetic. Echocardiography (ECHO) revealed abundant pericardial effusion with diastolie right atrial and ventricular collaps, specific for cardiac tamponade. By pericardiocentesis, 4200 ml of hemorrhagic fluid was removed. Dyspnea and chest pain resolved. Control ECHO demonstrated only loculated effusion posteriorly. Besides mild anemia, laboratory tests, as well as the screening tests for viral, bacterial and immunological inflammation, were within normal limits. Due to close contact of the dislocated osteosinthetic material with the pericardim, observed by the chest rentgenogram and CT scan, iatrogenic mechanical trauma of the parietal pericardium was suspected and confirmed by explorative pericardiotomy, by which osteosinthetic material in the chest wall was removed. The patient recovered and was discharged few weeks later. Conclusion. After thoracic surgery iatrogenic trauma of the pericardium is possible. Chest rentgenogram or ECHO should be performed few weeks after operation, especially with new onset of dyspnea and chest pain in order to diagnose and treat eventual pericardial effusion as soon as possible to avoid the progression to cardiac tamponade.
Deskriptorji		PERICARDIAL EFFUSION CARDIAC TAMPONADE PERICARDIUM ADULT IATROGENIC DISEASE STERNUM