Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 11 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Trauma Cardiaco Penetrante. Es Posible el Manejo Conservador?

Napoleon Mendez, Mario Andrés Flores, Hamilton Aldany Gamarro

Keywords : Cardiac injuries, Cardiac trauma, Case report, Conservative treatment, Precordial wound, Penetrating heart injury

Citation Information : Mendez N, Flores MA, Gamarro HA. Trauma Cardiaco Penetrante. Es Posible el Manejo Conservador?. Panam J Trauma Crit Care Emerg Surg 2022; 11 (2):99-101.

DOI: 10.5005/jp-journals-10030-1384

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background: Opening the chest is the accepted standard for a positive pericardial window in patients with wounds in the cardiac area, in all cases. However, in recent years there have been some reports of good results without opening the chest, only draining the hemopericardium in stable patients and nonpersistent hemopericardium. Selection should be made exclusively in patients with stable hemodynamics, without active bleeding, and without signs of tamponade, under controlled conditions with monitoring capacity and experience. Description of the case: A 23-year-old female patient is reported, with stab wounds in the precordial region who is admitted to emergency services. Patient with stable hemodynamics, it is decided to take a laparoscopic pericardial window to the operating room to rule out cardiac injury, evidencing nonactive bleeding from a cardiac injury, it is managed without opening the chest after washing the pericardium and evidencing that the bleeding subsides spontaneously. The patient was discharged without complications, documenting success with conservative management, and avoiding thoracotomy. Conclusion: The management of penetrating cardiac injury can be conservative without opening the chest in the stable patient, and the injury has stopped actively bleeding. Although this management is feasible, these cases should be managed only by experts and should not yet be considered as the standard, until sufficient evidence is obtained.

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