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Impending cardiac herniation: the snow cone sign
Radiology
|December 1, 1986
Summary
Cardiac herniation and volvulus can occur after right pneumonectomy. Early radiographic signs, like a "snow cone" contour, can indicate impending herniation, allowing for risk factor modification.
Area of Science:
- Cardiothoracic Surgery
- Radiology
- Pathology
Background:
- Pneumonectomy, the surgical removal of a lung, can lead to complications.
- Cardiac herniation and volvulus are rare but serious post-pneumonectomy complications.
Observation:
- Two cases of cardiac herniation and volvulus following right pneumonectomy are presented.
- Asymptomatic patients showed an unusual bulging contour of the heart on immediate post-operative radiographs.
- This contour, resembling a 'snow cone,' was observed before complete herniation and volvulus occurred.
Findings:
- Partial cardiac herniation through a pericardial defect can create a distinct hemispheric contour.
- This radiographic finding is indicative of potential cardiac displacement and twisting.
Implications:
- Radiographic identification of this 'snow cone' sign is crucial for early detection.
- Increased clinical awareness can prompt modification of risk factors associated with cardiac herniation.
- Prompt recognition may improve patient outcomes after pneumonectomy.