ABSTRACT
El taponamiento pericárdico constituye una verdadera emergencia médica poco frecuente en la edad pediátrica. Mostramos un paciente de 16 años de edad que presentó una neumonía localizada en lóbulo superior izquierdo, complicada con un absceso pulmonar y derrame pleural homolateral asociado a un derrame pericárdico. Se inició tratamiento endovenoso con antibióticos de amplio espectro, drenaje pulmonar izquierdo y pericardiocentesis. A las 24 horas del postoperatorio presentó colapso circulatorio con aumento importante del derrame pericárdico. Se efectuó una tomografía computarizada de tórax y un ecocardiograma, mostrando un incremento del derrame pericárdico muy importante sin cambios en su patología pulmonar. Se realizó una ventana pericárdica por toracoscopia derecha, con mejoría clínica evidente y el ecocardiograma a las 24 horas del postoperatorio fue normal. El abordaje toracoscópico en casos de taponamiento pericárdico es una alternativa útil, beneficiando al paciente de las ventajas de los abordajes mínimamente invasivos (AU)
Pericardial tamponade is a rare medical emergency in children. We describe a 16 years old patient, who presented with pneumonia localized in upper left lobe complicated with lung abscess and ipsilateral pleural effusion, associated with pericardial effusion. The initial treatment was: broad-spectrum antibiotics, left thoracic drenage and pericardiocentesis After 24 hours postoperative, developed circulatory collapse with significant increase in pericardial effusion. The preoperative studies were thoracic CT-scann and echocardiography, showing an increase of pericardial effusion with no major changes in lung pathology. We performed a pericardial window by right thoracoscopic. After this, quickly improved clinically and the echocardiography 24 hours postoperatively was normal. The thoracoscopic approach in cases of pericardial tamponade is an useful alternative, benefiting the patient of minimally invasive approaches (AU)
Subject(s)
Humans , Male , Adolescent , Thoracoscopy , Cardiac Tamponade/surgery , Minimally Invasive Surgical Procedures/methods , Pericarditis/etiology , Pericardial Effusion/complications , Pneumonia/etiology , Lung Abscess/complicationsABSTRACT
Pericardial tamponade is a rare medical emergency in children. We describe a 16 years old patient, who presented with pneumonia localized in upper left lobe complicated with lung abscess and ipsilateral pleural effusion, associated with pericardial effusion. The initial treatment was: broad-spectrum antibiotics, left thoracic drenage and pericardiocentesis After 24 hours postoperative, developed circulatory collapse with significant increase in pericardial effusion. The preoperative studies were thoracic CT-scann and echocardiography, showing an increase of pericardial effusion with no major changes in lung pathology. We performed a pericardial window by right thoracoscopic. After this, quickly improved clinically and the echocardiography 24 hours postoperatively was normal. The thoracoscopic approach in cases of pericardial tamponade is an useful alternative, benefiting the patient of minimally invasive approaches.
