Citation

Verma N, Robinson JD, Gunn ML. Radiol. Case Rep. 2018; 13(3): 573-575.

Affiliation

University of Washington, Harborview Medical Center, Department of Radiology, 325 9th Ave., Seattle, WA 98104, USA.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.radcr.2018.02.013

PMID

29988807

PMCID

PMC6030551

Abstract

Pericardial rupture in blunt trauma is rarely seen on computed tomography (CT) imaging due to its high initial mortality. We report a case of a 53-year-old man who presented to the Emergency Department in hemodynamic shock after intentional fall from height. Chest radiograph, which was taken in the trauma bay as a part of his primary survey, showed abnormal mediastinum contour with pneumopericardium. Pericardial rupture with cardiac herniation, and tamponade secondary to pneumopericardium, was diagnosed on trauma CT scan. The patient underwent emergent surgical management with thoracotomy to reduce the herniation and repair the pericardium. Immediate suspicion for pericardial and cardiac injury on the initial chest radiograph and rapid diagnosis on CT was indispensable for this patient's favorable outcome.

Language: en

Keywords

Blunt trauma; Cardiac herniation; Chest trauma; Pericardial rupture; Tamponade