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Purulent Pericardial Effusion Treated by Incision and Drainage

MARTIN B. MYLES, M.D.; ROBERT B. PFEFFER, M.D.; PETER W. STONE, M.D.
AMA Arch Surg. 1957;75(2):287-292. doi:10.1001/archsurg.1957.01280140125023.
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The presence of a subacute or chronic pericarditis with effusion is not a common condition encountered on a surgical service. The surgeon is much more aware of acute pericardial tamponade secondary to penetrating wounds of the heart. Here the condition can easily be suspected by the site and type of injury, as well as the dramatic clinical picture and fairly typical signs.1,2 A small effusion into the pericardial sac may be quickly fatal, since there is little dilatation of the pericardium and shock can occur quickly. Elkin and Campbell3 have reported a case in which 5 cc. of blood in the pericardium has given a 0/0 arterial blood pressure. Subacute or chronic pericarditis, on the other hand, can lead to massive effusion without the striking clinical picture of acute tamponade. Yu et al.8 have reported a case in which pericardial aspiration yielded 1910 cc. of fluid on

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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