Pericarditis supurada y estallido pericárdico: Doble complicación excepcional en un politraumatizado grave

Luis Ruso; Valeria Porteiro; Carolina Fregosi; Mariella Rondan; José L. Núñez; Andrés Colet

Authors

Luis Ruso Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Quirúrgica "3", Clínica Quirúrgica, Profesor Agregado
Valeria Porteiro Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Quirúrgica "3", Clínica Quirúrgica, Asistente
Carolina Fregosi Hospital Maciel, Centro de Cuidados Intensivos, Residente
Mariella Rondan Universidad de la República, Facultad de Medicina, Departamento de Anatomía Patológica, Anatomía Patológica, Profesora Agregada
José L. Núñez Hospital Maciel, Centro de Cuidados Intensivos, Residente
Andrés Colet Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Quirúrgica "3", Clínica Quirúrgica, Profesor Adjunto

Keywords:

PERICARDITIS, PERICARDIAL EFFUSION, THORACIC INJURIES, WOUNDS BY A FIRE WEAPON

Abstract

Pericarditis is defined as the inflammation of the pericardial serous membrane. Acute pericarditis may be due to numerous causes. Among them, trauma is a very infrequent cause. Purulent bacterial pericarditis is even less frequent (0,26%); it is seen as a complication following an extra cardiac infectious focus and it can be fatal if it is not rapidly treated. Early diagnosis is usually difficult and it may not be evident and if it evolves naturally it may not be evident until certain degree of cardiac tamponade occurs.
The case of a serious traumatized patient is reported. It presented numerous infectious foci and at the second week after hospitalization it developed a bacterial pericarditis with pericardiac burst followed by acute empyema and septic shock, and only intrasurgical diagnosis was possible.
This finding allows us to conclude that during the course of serious thoracic trauma it is necessary to determine the presence of fluid in the pericardic cavity and to evaluate the occurrence of suppuration related to the presence of systemic infectious foci and positive haemocul-tures.

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