Pericardial laceration and fatal cardiac herniation in an improperly restrained six-month-old infant
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Journal of Pediatric Surgery
|November 1, 1986
Insights
A rare case of fatal cardiac herniation in an infant due to blunt chest trauma from an infant restraint device is presented. This condition, pleuropericardial laceration, requires suspicion in unresponsive electromechanical dissociation cases.
Area of Science:
- Pediatric Trauma
- Cardiovascular Surgery
- Forensic Pathology
Background:
- Blunt chest trauma can lead to severe thoracic injuries.
- Infant restraint devices, while crucial for safety, can pose risks if misused.
- Cardiac herniation is a rare but catastrophic complication of pericardial injury.
Observation:
- The study reports the youngest patient diagnosed with pleuropericardial laceration and fatal cardiac herniation.
- The injury was associated with blunt chest trauma, potentially linked to improper infant restraint device usage.
- The patient presented with electromechanical dissociation unresponsive to resuscitation.
Findings:
- Pleuropericardial laceration with cardiac herniation is an infrequent but critical outcome of blunt chest trauma.
- This case highlights a previously unreported severity of injury in pediatric patients.
- The mechanism suggests a link between restraint device misuse and severe cardiac trauma.
Implications:
- Increased awareness of potential risks associated with infant restraint devices is necessary.
- Clinicians should consider cardiac herniation in pediatric cases of electromechanical dissociation following chest trauma.
- Further research into the biomechanics of infant restraint devices and thoracic injury is warranted.
Abstract:
We present the youngest reported patient to suffer pleuropericardial laceration with fatal cardiac herniation from blunt chest trauma, apparently related to the improper use of an infant restraint device. Pericardial laceration with cardiac herniation occurs infrequently, but should be suspected in this setting when a patient in electromechanical dissociation is unresponsive to standard resuscitation measures.