[Traumatic rupture of the pericardium with left intrapleural luxation of the heart in a patient with multiple trauma]. / Rupture traumatique du péricarde avec luxation intra-pleurale gauche du coeur chez un polytraumatisé.

Traumatic rupture of the pericardium is a rare lesion usually associated with violent thoracic trauma and sudden deceleration. The case described herein is one of left intra-pleural luxation of the heart secondary to trauma which was asymptomatic for nine hours and was revealed by acute symptoms due to mobilisation of the patient. Diagnosis of this entity is difficult and is usually made in the acute multiple trauma setting. Although usually negative, lung films may be contributive; sonocardiogram, which should be obtained routinely in this setting, is often non-specific but usually provides the indication for thoracotomy. The most severe complication is extra-pericardic luxation of the heart with strangulation or volvulus, depending on the site and size of the pericardial tear. While all proven cases of pericardial rupture should be explored surgically, treatment varies for different teams according to the site and the size of the rupture.