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European Journal of Cardio-Thoracic Surgery, Vol 8, 106-107, Copyright © 1994 by European Association for Cardio-thoracic Surgery


ARTICLES

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.





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Copyright © 1994 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.