ACUTE ASCITES WITH BLUNT CARDIAC RUPTURE

A unique case of acute ascites following blunt cardiac rupture is reported. A 32-year-old woman was admitted to another hospital and transferred to the authors' institution in cardiopulmonary shock with a very distended abdomen 2.5 h after a motor vehicle accident. Laparotomy was immediately performed and revealed 4 to 5 L of crystal clear fluid and a severe liver congestion. Cardiac tamponade was suspected and confirmed through a transdiaphragmatic pericardial window. Sternotomy was performed and a single right atrial appendage laceration identified, which was successfully repaired. The literature regarding blunt traumatic cardiac rupture is briefly reviewed, and the possible pathophysiology of ascites in a blunt traumatic cardiac rupture is discussed.