A CASE OF TENSION PNEUMOPERICARDIUM IN BLUNT TRAUMA TREATED USING AN ANTERIOR PARASTERNAL APPROACH

• Published in: Journal of the Japanese Association for the Surgery of Trauma Vol. 38; no. 3; pp. 461 - 465
• Main Authors: MATSUMOTO, Hisatake, IRISAWA, Taro, EBIHARA, Takeshi, ODA, Jun, OKAMOTO, Keishi, KATAYAMA, Yusuke, ISHIMURA, Yurie, SHIMAZAKI, Junya
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for the Surgery of Trauma 20.07.2024; 一般社団法人 日本外傷学会
• Subjects: anterior parasternal approach; cardiocentesis; tension pneumopericardium; 心膜開窓術; 緊張性心嚢気腫; 胸骨左縁アプローチ
• ISSN: 1340-6264; 2188-0190
• DOI: 10.11382/jjast.38.3_07

We report a case of a 41-year-old male who was injured in a traffic accident and transported to our hospital. Whole-body computed tomography (CT) revealed right pneumothorax, pneumopericardium, and intraperitoneal hemorrhage due to mesenteric injury. He developed hemorrhagic shock. Emergency laparotomy was performed to achieve hemostasis, and open abdomen management (OAM) was initiated. We determined that the pericardium and right pleural cavity were communicating ; therefore, right chest drainage was performed to treat his pneumopericardium and right pneumothorax. In the intensive care unit, the patient developed obstructive shock due to tension pneumopericardium. As OAM may have created communication between the pericardium and the intra-abdominal space, pericardium drainage was performed using an anterior parasternal approach rather than a subxiphoid approach. The patient recovered from his shock episode following the drainage procedure and was discharged home on day 52 following his admission to the hospital.