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A "Vanishing", Tuberculous, Pericardial Effusion

Jacques Liebenberg1, Pieter van der Bijl2

  • 1Department of Internal Medicine, Kimberley Provincial Hospital, Du Toitspan Road, Kimberley Hospital, Kimberley, South Africa.

Korean Circulation Journal
|November 10, 2016
PubMed

Insights

A rare complication of pericardiocentesis, a pleuro-pericardial connection, can occur after draining large tuberculous pericardial effusions. Recognizing this iatrogenic injury prevents further harm to the heart and coronary arteries during aspiration attempts.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Pericardiocentesis is a procedure to drain fluid from the pericardial sac.
  • Tuberculous pericardial effusion can lead to large fluid accumulation.
  • Iatrogenic complications can arise from invasive procedures.

Purpose of the Study:

  • To describe an iatrogenic pleuro-pericardial connection.
  • To highlight the importance of recognizing this complication after pericardiocentesis.
  • To prevent further injury during aspiration attempts.

Main Methods:

  • Case presentation of a patient with tuberculous pericardial effusion.
  • Description of pericardiocentesis procedure.
  • Analysis of the resulting pleuro-pericardial connection.

Main Results:

  • An iatrogenic connection between the pleura and pericardium was identified.
  • This complication occurred after pericardiocentesis for a large tuberculous effusion.
  • Failure to aspirate fluid post-initial puncture indicated the complication.

Conclusions:

  • Pleuro-pericardial connection is a potential iatrogenic complication of pericardiocentesis.
  • Clinical awareness is crucial for prompt diagnosis.
  • Early recognition prevents myocardial and coronary artery injury.

Keywords:
EchocardiographyPericardial effusionPleural cavityTuberculosis

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