Purulent Pericardial Effusion Treated by Incision and Drainage

The presence of a subacute or chronic pericarditis with effusion is not a common condition encountered on a surgical service. The surgeon is much more aware of acute pericardial tamponade secondary to penetrating wounds of the heart. Here the condition can easily be suspected by the site and type of injury, as well as the dramatic clinical picture and fairly typical signs.¹,²A small effusion into the pericardial sac may be quickly fatal, since there is little dilatation of the pericardium and shock can occur quickly. Elkin and Campbell³have reported a case in which 5 cc. of blood in the pericardium has given a 0/0 arterial blood pressure. Subacute or chronic pericarditis, on the other hand, can lead to massive effusion without the striking clinical picture of acute tamponade. Yu et al.⁸have reported a case in which pericardial aspiration yielded 1910 cc. of fluid on