ACUTE ASCITES WITH BLUNT CARDIAC RUPTURE

A unique case of acute ascites following blunt cardiac rupture is repo rted. A 32-year-old woman was admitted to another hospital and transfe rred to the authors' institution in cardiopulmonary shock with a very distended abdomen 2.5 h after a motor vehicle accident. Laparotomy was immediately performed and revealed 4 to 5 L of crystal clear fluid an d a severe liver congestion. Cardiac tamponade was suspected and confi rmed through a transdiaphragmatic pericardial window. Sternotomy was p erformed and a single right atrial appendage laceration identified, wh ich was successfully repaired, The literature regarding cardiac ruptur e is briefly reviewed, and the possible pathophysiology of ascites in a blunt traumatic cardiac rupture is discussed.