[Intrapericardial rupture of the inferior vena cava caused by blunt trauma]

A thirty-years-old man with pectus excavatum was unconscious, in shock and with a history of blunt trauma of the chest and epigastrium admitted to hospital. After a short time he developed signs of pericardial and peritoneal effusion with tamponade and circulatory failure. Urgent laparotomy and sternotomy was performed. We found approximately a 5 cm long rupture of the right atrium, anterior wall of the intrapericardial part of the vena cava inferior with short extension to the infradiaphragmatic part of the vena cava inferior. We controlled bleeding by hand and by application of a Satinsky partial vascular clamp. Final plastic correction of the rupture was performed by implantation of a native autologous pericardial flap. After a complicated postoperative course the patient was discharged on the 37th postoperative day. Seven months after surgery the patient is in a good condition and has no signs of stenosis at the place of correction.