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Eur J Cardiothorac Surg 2002;21:121-123
© 2002 Elsevier Science NL

Case report

Delayed heart perforation after blunt trauma

^a Division of General Thoracic Surgery, University Hospital, 3010 Berne, Switzerland
^b Division of Cardiovascular Surgery, University Hospital, Berne, Switzerland
^c Division of Intensive Care Medicine, University Hospital, Berne, Switzerland

Received 30 April 2001; received in revised form 21 September 2001; accepted 14 October 2001.

* Corresponding author. Tel.: +41-31-632-2330; fax: +41-31-632-2327
e-mail: ralph.schmid{at}insel.ch

A 33-year-old patient was hospitalized after a blunt chest trauma with a left flail chest. Six hours after admission to the intensive care unit the patient suddenly developed hypotension and tachycardia. His left chest tube drained 1.5 l of blood within minutes. Immediate resuscitation and emergency sternotomy with left anterolateral extension was performed for pericardial tamponade secondary to left ventricular perforation due to a sharp rib fragment. Outcome was favourable and the patient was operated on for his flail chest by internal stabilization the next day.

Key Words: Heart perforation • Ventricle laceration • Lung perforation • Blunt chest trauma • Flail chest