European Journal of Cardio-Thoracic Surgery, Vol 8, 106-107, Copyright © 1994 by European Association for Cardio-thoracic Surgery
Cardiac tamponade secondary to intrapericardial rupture of a hepatic amoebic abscess
AM Perna and GF Montesi
Divisione di Cardiochirurgia, Policlinico Careggi, Firenze, Italy.
We report the case of a patient who underwent an emergency subxiphoid
pericardiectomy with evacuation of 1700 cc of anchovy sauce-like fluid. On
pericardial inspection a fistulous communication was seen with a cavity in
the left hepatic lobe. No loculi or adhesions were found in the pericardial
sac and no further surgical procedure was advised. The hepatic cavity and
pericardium were drained: bacteriological investigation of the fluid
yielded entamoeba histolytica and chloroquine was administered. Apart from
the rarity of the observation in western countries, we discuss surgical
approaches in cases of unknown purulent pericardial effusions, stressing
the possibility of achieving a good surgical result even with a minor
surgical procedure such as subxiphoid pericardiectomy and drainage.