Abstract：
OBJECTIVE: To describe the unique finding and treatment of a dog with cardiac herniation due to traumatic pericardial rupture.
METHODS: A 6.5-year-old entire male Yorkshire Terrier was presented for further management after being hit by a car. Despite suspected significant intrathoracic trauma at that time, the patient regained hemodynamic stability and had orthopedic surgery to correct a right iliac fracture. The patient was readmitted to the hospital 12 days following the initial visit due to considerable respiratory difficulty after accidentally being dropped several feet. Thoracic radiographs revealed an unusual severe mediastinal shift to the left with an atypical position of the cardiac silhouette against the left lateral thoracic wall. Due to the severe respiratory compromise of the patient and newly developed pneumothorax, an exploratory thoracotomy was recommended, where a complete rupture of the pericardium was identified, with secondary left-sided prolapse of the heart. Other more common intrathoracic injuries (ie, lung perforation, rib fractures) were also identified and partially repaired. The patient recovered successfully and was discharged 4 days postoperatively.
CONCLUSIONS: This is the first case report in the veterinary literature of traumatic pericardial rupture and cardiac herniation. According to human case descriptions, this is a rare and often fatal occurrence, which can be significantly challenging to diagnose preoperatively or antemortem. Emergency veterinary clinicians should be aware of this rare but important complication of blunt thoracic trauma. Surgical intervention may be necessary in cases with suspected or confirmed entrapment of great vessels or cardiac chambers, although these abnormalities were not present in this case.
METHODS: A 6.5-year-old entire male Yorkshire Terrier was presented for further management after being hit by a car. Despite suspected significant intrathoracic trauma at that time, the patient regained hemodynamic stability and had orthopedic surgery to correct a right iliac fracture. The patient was readmitted to the hospital 12 days following the initial visit due to considerable respiratory difficulty after accidentally being dropped several feet. Thoracic radiographs revealed an unusual severe mediastinal shift to the left with an atypical position of the cardiac silhouette against the left lateral thoracic wall. Due to the severe respiratory compromise of the patient and newly developed pneumothorax, an exploratory thoracotomy was recommended, where a complete rupture of the pericardium was identified, with secondary left-sided prolapse of the heart. Other more common intrathoracic injuries (ie, lung perforation, rib fractures) were also identified and partially repaired. The patient recovered successfully and was discharged 4 days postoperatively.
CONCLUSIONS: This is the first case report in the veterinary literature of traumatic pericardial rupture and cardiac herniation. According to human case descriptions, this is a rare and often fatal occurrence, which can be significantly challenging to diagnose preoperatively or antemortem. Emergency veterinary clinicians should be aware of this rare but important complication of blunt thoracic trauma. Surgical intervention may be necessary in cases with suspected or confirmed entrapment of great vessels or cardiac chambers, although these abnormalities were not present in this case.
摘要：
目的：描述因创伤性心包破裂导致心脏疝的狗的独特发现和治疗。
方法：一辆6.5岁的整只雄性约克郡梗在被车撞后被送去进一步管理。尽管当时怀疑有严重的胸内外伤，患者恢复了血流动力学稳定,并进行了矫形手术以矫正右髂骨折.患者在初次就诊后12天由于意外跌落几英尺后出现严重的呼吸困难而再次入院。胸片显示，纵隔向左不寻常的严重移位，心脏轮廓相对于左胸壁的位置不典型。由于患者严重的呼吸损害和新出现的气胸，建议进行剖胸探查,发现心包完全破裂，继发性心脏左侧脱垂。其他更常见的胸腔内损伤（即，肺穿孔,肋骨骨折）也被确认并部分修复。患者康复成功，术后4天出院。
结论：这是兽医文献中首例外伤性心包破裂和心脏疝的病例报告。根据人类案例描述，这是一种罕见且经常致命的事件，这对于术前或死前诊断可能是非常具有挑战性的。急诊兽医临床医生应该意识到钝性胸部创伤的这种罕见但重要的并发症。在怀疑或确认大血管或心腔阻塞的情况下，可能需要进行手术干预。尽管在这种情况下不存在这些异常。
方法：一辆6.5岁的整只雄性约克郡梗在被车撞后被送去进一步管理。尽管当时怀疑有严重的胸内外伤，患者恢复了血流动力学稳定,并进行了矫形手术以矫正右髂骨折.患者在初次就诊后12天由于意外跌落几英尺后出现严重的呼吸困难而再次入院。胸片显示，纵隔向左不寻常的严重移位，心脏轮廓相对于左胸壁的位置不典型。由于患者严重的呼吸损害和新出现的气胸，建议进行剖胸探查,发现心包完全破裂，继发性心脏左侧脱垂。其他更常见的胸腔内损伤（即，肺穿孔,肋骨骨折）也被确认并部分修复。患者康复成功，术后4天出院。
结论：这是兽医文献中首例外伤性心包破裂和心脏疝的病例报告。根据人类案例描述，这是一种罕见且经常致命的事件，这对于术前或死前诊断可能是非常具有挑战性的。急诊兽医临床医生应该意识到钝性胸部创伤的这种罕见但重要的并发症。在怀疑或确认大血管或心腔阻塞的情况下，可能需要进行手术干预。尽管在这种情况下不存在这些异常。
