Pericardial tamponade type injury: A 17-year study in an urban trauma center in Japan

We defined injuries to the heart and the pericardium together with hemoperi cardium as pericardial tamponade type injury regardless of symptoms or sign s due to pericardial tamponade. The aim of the study is to examine the impo rtant factors related to the diagnosis and treatment of this type of injury . A retrospective chart review was conducted of traumatized patients admitt ed with hemopericardium to our institution between 1978 and 1995. Ten out o f the 19 consecutive patients,vith pericardial tamponade type injury demons trated shock and showed a higher Injury Severity Score and mortality (7/11) than the remaining 9 without shock. The majority of our cases received an emergency room thoracotomy or a surgical fenestration and thereafter some o f them needed a (re-)thoracotomy in the operating room. We consider a fenes tration through the pericardium to be the first choice for the relief of ac ute hemopericardium due to trauma, while surgeons should not perform perica rdiocentesis for the either diagnosis or relief of this type of injury.