Key result
A 46-year-old male with blunt chest trauma and fluctuating vital signs was incidentally found to have a traumatic pericardial rupture during surgical stabilization of a flail chest, which was successfully repaired.
Why the study?
Post-traumatic blunt pericardial injury is rare, and injuries not severe enough to immediately dislocate the heart may present only with intermittent ECG changes or be asymptomatic.
Case Report (n=1)
Post-traumatic blunt pericardial ruptures should be considered in patients with blunt chest trauma showing abnormal vital signs and ECG changes, even if initial imaging is negative.
Incidental pericardial repair during rib fixation warrants vigilance in blunt chest trauma; Level 5 evidence leaves open screening impact.
BACKGROUND: Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission. However, pericardial injuries not bad enough to dislocate the heart may only cause intermittent electrocardiogram (ECG) changes or be asymptomatic. CASE SUMMARY: In this case, we report a blunt pericardial injury undetected on preoperative transthoracic echocardiography and chest computed tomography. We misjudged intermittent ECG changes and blood pressure fluctuations as minor symptoms resulting from cardiac contusion and did not provide intensive treatment. The pericardial injury was found incidentally during surgical stabilization of rib fractures and was successfully repaired. CONCLUSION: Post-traumatic blunt pericardial ruptures should be considered in patients with blunt chest trauma showing abnormal vital signs and ECG changes.
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Yoon et al. (2022) conducted a case report in Post-traumatic blunt pericardial injury and flail chest (n=1). Surgical stabilization of rib fractures and pericardial repair was evaluated. A 46-year-old male with blunt chest trauma and fluctuating vital signs was incidentally found to have a traumatic pericardial rupture during surgical stabilization of a flail chest, which was successfully repaired.
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