Postpericardiotomy syndrome: its diagnosis and treatment after muscle flap closure of an infected sternal wound.

Abstract

After nearly any form of cardiac surgery, an acute febrile illness characterized by leukocytosis, pericarditis with pericardial effusion, and pleural effusion may occur. In some instances, this postpericardiotomy syndrome may suggest the presence of mediastinal infection. Treatment of postpericardiotomy syndrome is conservative, and symptoms typically resolve with nonsteroidal antiinflammatory medication. We report a case of postpericardiotomy syndrome that mimicked recurrent mediastinal infection and developed after muscle flap closure of an infected sternal wound. Pericardial, pleural, and periflap fluid accumulated postmuscle flap closure and was sterile on culture. A diagnosis of postpericardiotomy syndrome was made, and the patient improved while receiving oral indomethacin. She has remained free of infection as of the 2-year follow-up.

• Authors: M L Workman, R Blinkhorn, A A Smith
• Journal: Plastic and reconstructive surgery (Plast Reconstr Surg) Vol. 96 Issue 3 Pg. 725-7 (Sep 1995) ISSN: 0032-1052 [Print] United States
• PMID: 7638300 (Publication Type: Case Reports, Journal Article)

Topics

• Diagnostic Errors
• Female
• Humans
• Middle Aged
• Postpericardiotomy Syndrome (diagnosis, therapy)
• Recurrence
• Sternum (surgery)
• Surgical Flaps
• Surgical Wound Infection (diagnosis, surgery)