[Late post-traumatic pericardial effusion. Identification of promoting conditions and literature review apropos of 2 cases].

The authors report two cases of post traumatic haemopericardium discovered 18 days after a iatrogenic penetrating trauma (sternal puncture) for the first one, and 102 days after a fall with blunt thoracic trauma and multiple associated injuries, for the second one. After admission, the first case rapidly developed a severe tamponade requiring a pericardial drainage, of 420 ml of non coagulated blood. The second case, in spite of a volume of liquid of more than 1000 ml, showed only a fatigue and a dyspnea, without any sign of haemodynamic failure. A literature review allows to be more specific about the characteristics of the tamponade and the different mechanisms responsible for cardiac injuries connected to thoracic traumas. For many reasons, the cardiac damages and/or their complications are often misjudged, particularly in thoracic traumas associated with multiple lesions. Among the sequelae, pericarditis, with or without effusion, is particularly frequent and it is essential to systematically look for it before dismissing a patient who went through a thoracic trauma. As for the bone marrow sampling, the sternal puncture generates a great number of injuries and must be proscribed. The iliac crest puncture should take its place.