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South African Journal of Surgery

versión On-line ISSN 2078-5151
versión impresa ISSN 0038-2361


WAIN, H et al. Transdiaphragmatic pericardial washout post penetrating cardiac injury found incidentally at diagnostic laparoscopy. S. Afr. j. surg. [online]. 2022, vol.60, n.4, pp.321-323. ISSN 2078-5151.

A 22-year-old male presented following a precordial stab. He was haemodynamically and metabolically normal. Initial investigations did not reveal pericardial fluid or haemothorax. At diagnostic laparoscopy, we encountered haemoperi-toneum and a diaphragmatic injury through which the heart was visible. After pericardial washout, laparoscopic repair was effected. This case highlights a potential problem with extended focused assessment with sonography in trauma (eFAST) in that it will only be positive if there is an accumulation of pericardial fluid. It also confirms the utility of diagnostic laparoscopy for penetrating left thoracoabdominal injuries and shows that principles of open surgery can be safely applied laparoscopically in select patients.

Palabras clave : left thoracoabdominal penetrating injury; penetrating cardiac injury; diagnostic laparoscopy; stab heart; eFAST.

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