subxiphoid fenestration

Pericardial injuries can be caused by pleural-pericardial laceration and hernia-pericardial laceration. The former can cause pericardium, left or right pleural-pericardial tear due to blunt impact from the anterior direction; and can cause myocardial contusion. -pericardial laceration often coexists with diaphragmatic rupture. Simple pericardial laceration, if the mouth is small, can produce blood pericardial or acute cardiac tamponade; if the breach is larger, the most critical situation is the occurrence of cardiac dislocation and intrusion into the pleural cavity, called pericardium. In the case of a pericardial laceration, the abdominal organs can also enter the pericardial cavity, the latter being called the pericardium. Dislocated heart, or abdominal organs can cause severe circulatory dysfunction if incarcerated at the rupture. Treatment of diseases: pericardial effusion Indication When the pericardium is used for pericardial puncture, about 25% of the cases cannot produce blood. At this time, there are still symptoms of acute cardiac tamponade, and the pericardial fenestration can be done immediately. Contraindications A small amount of blood in the pericardium and enlarged heart is a taboo for pericardial fenestration. Surgical procedure 1. 5cm incision in the midline of the lower flank of the xiphoid process, and cut the white line of the abdomen. 2. Remove the xiphoid process, push the pleura on both sides, push the diaphragm apart, and then cut the happy bag. 3. Pull the sternum fracture to open a small window on the anterior lower pericardium, and use the 4-needle traction line to suspend the pericardium to remove the blood in the pericardial cavity. 4. Exploring and stopping bleeding, no active bleeding points, placement of the pericardial drainage tube, loosening the upper abdominal incision. 5. If you find that the pericardial cavity is still bleeding, immediately make a chest midline incision, enlarge the pericardial incision, find the source of bleeding, suture the heart or medullary wound.