Non-Hemorrhagic Pericardial Effusion in Penetrating Thoracic Trauma from Incidental Coxsackie B Virus

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Author Info

Kathryn Haberman Pamela Souders Joyce Sanchez Jill Streams Christopher Davis

Corresponding Author

Kathryn Haberman
Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Wisconsin, USA

A B S T R A C T

Cardiac ultrasound is an integral part of the assessment and evaluation of penetrating thoracic trauma. Positive findings of pericardial fluid are an indication for subxiphoid pericardial window and/or sternotomy. Little has been published regarding non-hemorrhagic pericardial effusions in the setting of penetrating thoracic trauma. We present the first reported case of non-hemorrhagic pericardial effusion following a thoracic gunshot wound (GSW) incidentally caused by Coxsackie B virus and discuss our review of the literature. A 19-year-old male presented to the Emergency Department following GSWs to the face, hand, and thorax. The patient was hemodynamically normal; however, a pericardial effusion was noted on cardiac ultrasound, as was a large left-sided hemothorax. The patient was brought emergently to the operating room where a pericardial window demonstrated a large, non-hemorrhagic pericardial effusion. Laboratory analysis was consistent with current Coxsackie B viral infection. All other evaluations returned negative. As there are no guidelines for this population, we propose guidelines for the work-up of non-hemorrhagic pericardial effusion in the setting of penetrating thoracic trauma. We also discuss the safety and efficacy of a pericardial window in a hemodynamically normal patient with concern for hemopericardium prior to performing a median sternotomy.

Article Info

Article Type

Case Report and Review of the Literature

Publication history

Received: Thu 02, Jun 2022
Accepted: Fri 17, Jun 2022
Published: Thu 30, Jun 2022

Copyright

© 2023 Kathryn Haberman. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.IJSCR.2022.01.01