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Traumatic cardiac rupture with acute ascites.

T Koyama1, S Miyamoto, H Murakami

  • 1Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|October 13, 2000
PubMed
Summary

A rare case of serous ascites occurred after traumatic cardiac rupture in a young man with severe shock. The ascites may be linked to cardiac tamponade and fluid resuscitation following the cardiac injury.

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Area of Science:

  • Emergency Medicine
  • Cardiovascular Surgery
  • Trauma Surgery

Background:

  • Traumatic cardiac rupture is a rare but life-threatening injury.
  • Motorcycle accidents are a common cause of severe trauma.
  • Ascites, or abdominal fluid accumulation, is an unusual complication of cardiac trauma.

Observation:

  • A 21-year-old male presented with severe shock after a motorcycle accident.
  • Computed tomography revealed pericardial and intrapelvic fluid, suggesting cardiac and visceral injuries.
  • Emergency sternotomy identified and repaired a ruptured right atrial appendage.

Findings:

  • Postoperatively, moderate serous ascites was observed.
  • Laparotomy confirmed clear, non-bloody ascites, retroperitoneal edema, and hepatic congestion.

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  • No other organ injuries were identified.

    • Implications:

    • This case highlights a rare presentation of serous ascites post-cardiac rupture.
    • The ascites pathogenesis is hypothesized to involve portal venous congestion from cardiac tamponade and fluid resuscitation.
    • Understanding this complication is crucial for managing hemodynamically unstable trauma patients.