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Purulent Pericardial Effusion Treated by Incision and Drainage

Purulent Pericardial Effusion Treated by Incision and Drainage Abstract The presence of a subacute or chronic pericarditis with effusion is not a common condition encountered on a surgical service. The surgeon is much more aware of acute pericardial tamponade secondary to penetrating wounds of the heart. Here the condition can easily be suspected by the site and type of injury, as well as the dramatic clinical picture and fairly typical signs.1,2 A small effusion into the pericardial sac may be quickly fatal, since there is little dilatation of the pericardium and shock can occur quickly. Elkin and Campbell3 have reported a case in which 5 cc. of blood in the pericardium has given a 0/0 arterial blood pressure. Subacute or chronic pericarditis, on the other hand, can lead to massive effusion without the striking clinical picture of acute tamponade. Yu et al.8 have reported a case in which pericardial aspiration yielded 1910 cc. of fluid on References 1. Blalock, A., and Ravitch, M. M.: A Consideration of the Nonoperative Treatment of Cardiac Tamponade Resulting from Wounds of the Heart , Surgery 14:157, 1943. 2. Elkin, D. C.: Wounds of the Heart , Ann. Surg. 120:817, 1944.Crossref 3. Elkin, D. C., and Campbell, R. E.: Cardiac Tamponade: Treatment by Aspiration , Ann. Surg. 133:623, 1951.Crossref 4. Goyette, E. M.: Acute Idiopathic Pericarditis , Ann. Int. Med. 39:1032, 1953.Crossref 5. Kinsell, L. W., and Jahn, J. P.: Combined Hormonal-Antibiotic Therapy in Patients with Fulminating Infections , A. M. A. Arch. Int. Med. 96:418, 1955.Crossref 6. Proudfit, W. L., and Effler, D. B.: Diagnosis and Treatment of Chronic Pericarditis by Pericardial Biopsy , J.A.M.A. 161:188, 1956.Crossref 7. Williams, C., and Soutter, L.: Pericardial Tamponade: Diagnosis and Treatment , A. M. A. Arch. Int. Med. 94:571, 1954.Crossref 8. Yu, P. N. G.; Lovejoy, F. W.; Joos, H. A.; Nye, R. E., Jr., and Simpson, J. H.: An Unusual Case of Massive Pericardial Effusion with Hemodynamic Studies , Ann. Int. Med. 39:928, 1953.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Purulent Pericardial Effusion Treated by Incision and Drainage

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280140125023
Publisher site
See Article on Publisher Site

Abstract

Abstract The presence of a subacute or chronic pericarditis with effusion is not a common condition encountered on a surgical service. The surgeon is much more aware of acute pericardial tamponade secondary to penetrating wounds of the heart. Here the condition can easily be suspected by the site and type of injury, as well as the dramatic clinical picture and fairly typical signs.1,2 A small effusion into the pericardial sac may be quickly fatal, since there is little dilatation of the pericardium and shock can occur quickly. Elkin and Campbell3 have reported a case in which 5 cc. of blood in the pericardium has given a 0/0 arterial blood pressure. Subacute or chronic pericarditis, on the other hand, can lead to massive effusion without the striking clinical picture of acute tamponade. Yu et al.8 have reported a case in which pericardial aspiration yielded 1910 cc. of fluid on References 1. Blalock, A., and Ravitch, M. M.: A Consideration of the Nonoperative Treatment of Cardiac Tamponade Resulting from Wounds of the Heart , Surgery 14:157, 1943. 2. Elkin, D. C.: Wounds of the Heart , Ann. Surg. 120:817, 1944.Crossref 3. Elkin, D. C., and Campbell, R. E.: Cardiac Tamponade: Treatment by Aspiration , Ann. Surg. 133:623, 1951.Crossref 4. Goyette, E. M.: Acute Idiopathic Pericarditis , Ann. Int. Med. 39:1032, 1953.Crossref 5. Kinsell, L. W., and Jahn, J. P.: Combined Hormonal-Antibiotic Therapy in Patients with Fulminating Infections , A. M. A. Arch. Int. Med. 96:418, 1955.Crossref 6. Proudfit, W. L., and Effler, D. B.: Diagnosis and Treatment of Chronic Pericarditis by Pericardial Biopsy , J.A.M.A. 161:188, 1956.Crossref 7. Williams, C., and Soutter, L.: Pericardial Tamponade: Diagnosis and Treatment , A. M. A. Arch. Int. Med. 94:571, 1954.Crossref 8. Yu, P. N. G.; Lovejoy, F. W.; Joos, H. A.; Nye, R. E., Jr., and Simpson, J. H.: An Unusual Case of Massive Pericardial Effusion with Hemodynamic Studies , Ann. Int. Med. 39:928, 1953.Crossref

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Aug 1, 1957

References