Hemopericardio por disparo sin lesión cardíaca, descripción de un mecanismo de trauma

For many centuries heart wounds were considered fatal. Currently cardiac trauma remains one of the most lethal injuries. The results of patients with penetrating cardiac injury (PCI) can range from lethal lesions to arrhythmias that resolve spontaneously. Haemopericardium in trauma is usually due to penetrating cardiac injury, but the pericardial sac may fill with blood from large vessels and rupture of the pericardiophrenic artery associated with pericardial contusion laceration. Methods: For the organization of this study, a literature review was performed. Two cases were identified by the general surgery team in describing this rare mechanism of trauma. Results: Description of a different cause of hemopericardium, caused by blood from the peritoneal cavity. Discussion: In the cases presented, the firearm injury broke the barrier between the pericardial and peritoneal cavities (diaphragm), placing cavities with different pressure levels in contact, favoring the entry of blood from the peritoneal cavity into the pericardial sac. Conclusion: In the observed cases the projectile passed very close to the heart, but without injury it. Rupture on the diaphragmatic surface of the pericardium allowed the pressure of the peritoneal cavity to be equal to the pressure of the pericardium.