CARDIAC-TAMPONADE SECONDARY TO INTRAPERICARDIAL RUPTURE OF A HEPATIC AMEBIC-ABSCESS

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 investig ation of the fluid yielded entamoeba histolytica and chloroquine was a dministered. Apart from the rarity of the observation in western count ries, we discuss surgical approaches in cases of unknown purulent peri cardial effusions, stressing the possibility of achieving a good surgi cal result even with a minor surgical procedure such as subxiphoid per icardiectomy and drainage.