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The Annals of Thoracic Surgery, Vol 56, 506-509, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Two-dimensional echocardiography in the evaluation of penetrating intrapericardial injuries

JW Bolton, RP Bynoe, HL Lazar and CH Almond
Department of Surgery, University of South Carolina, Columbia.

Patients with penetrating pericardial trauma whose vital signs stabilize after fluid administration may present a therapeutic dilemma. Two-dimensional echocardiography has emerged as a diagnostic technique to help determine whether surgical intervention may be required. We present 5 patients with penetrating pericardial trauma whose vital signs stabilized after fluid administration and who had minimal clinical findings. In 3 of these patients, a small effusion was seen; in 2 others, no abnormalities were noted. All 5 underwent surgical exploration and had major intrapericardial injuries. We conclude that a normal echocardiographic study does not rule out major intrapericardial injury in patients with penetrating chest trauma. Furthermore, small areas of effusion seen on echocardiography in these patients represent indications for surgical exploration.

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