Subxiphoid pericardial window to exclude occult cardiac injury after penetrating thoracoabdominal trauma. Issue 11 (8th August 2013)

• Record Type: Journal Article
• Authors: Hommes, M.; Nicol, A. J.; van der Stok, J.; Kodde, I.; Navsaria, P. H.
• Is Part Of: British journal of surgery. Volume 100:Issue 11(2013:Nov.)
• Page Start: 1454
• Page End: 1458
• Publication Date: 2013-08-08
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.9241
• Languages: English
• ISSNs: 0007-1323

Abstract

<abstract abstract-type="main" id="bjs9241-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjs9241-sec-0001" sec-type="section"> <title>Background</title> <p id="bjs9241-para-0001"> <bold>An occult cardiac injury may be present in patients with an acute abdomen after penetrating thoracoabdominal trauma. This study assessed the use of a subxiphoid pericardial window (SPW) as a diagnostic manoeuvre in this setting.</bold> </p> </sec> <sec id="bjs9241-sec-0002" sec-type="section"> <title>Methods</title> <p id="bjs9241-para-0002"> <bold>This was a retrospective review of a trauma database (2001–2009). Patients presenting with a penetrating thoracoabdominal injury with an acute abdomen, and in whom there was concern about a potential cardiac injury from the site or tract of the injury, were included.</bold> </p> </sec> <sec id="bjs9241-sec-0003" sec-type="section"> <title>Results</title> <p id="bjs9241-para-0003"> <bold>Fifty patients with an indication for emergency laparotomy underwent a SPW for a possible cardiac injury. An occult haemopericardium was present at SPW in 14 patients (28 per cent) mandating, median sternotomy. Nine cardiac injuries (18 per cent) were identified including five tangential injuries and four perforations. The specific complication rate relating to the SPW was 2 per cent.</bold> </p> </sec> <sec id="bjs9241-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="bjs9241-para-0004"> <bold>The SPW is a useful technique at laparotomy to identify cardiac injuries in patients with penetrating thoracoabdominal injuries.</bold> </p> </sec> </abstract>