Kathryn Haberman,Pamela Souders,Joyce Sanchez,Jill Streams,Christopher Davis,
Non-Hemorrhagic Pericardial Effusion in Penetrating Thoracic Trauma from Incidental Coxsackie B Virus
International Journal of Surgical Case Reports
2022
2674-4171
http://dx.doi.org/10.31487/j.IJSCR.2022.01.01
https://www.sciencerepository.org/non-hemorrhagic-pericardial-effusion_IJSCR-2022-1-101 
Abstract: 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.Keywords: Non-hemorrhagic pericardial effusion, serous pericardial effusion, penetrating thoracic trauma, penetrating cardiac injury, pericardial window, Coxsackie B virus