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A case of post-pericardiotomy syndrome after extended thymectomy for invasive thymoma

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  • 浸潤性胸腺腫に対する拡大胸腺摘出術後に心膜切開後症候群を来した1例

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Abstract

<p>A 57-year-old man presented with a 36-mm mass lesion in the anterior mediastinum detected by chest computed tomography during follow-up for a thoracic aortic aneurysm. Invasive thymoma was suspected and extended thymectomy was performed through median sternotomy. Intraoperatively, the local pericardium putatively affected by tumor invasion was excised and the pericardial defect site was reconstructed with a Gore-Tex sheet. High fever, pericardial effusion, and ST elevation on electrocardiography were observed on the 8th day after surgery (diagnosed as post-pericardiotomy syndrome) but colchicine and NSAID administration resulted in renal impairment. An increase in pericardial effusion accompanied by marked growth of the septal wall was treated with thoracoscopic pericardial fenestration on the 15th day after surgery. Post-surgically, steroid administration was started and pericardial effusion was reduced, the fever went down, and the white blood cell count and CRP value normalized. Post-pericardiotomy syndrome is a relatively well-known complication after cardiac surgery, but it should be considered as a possibility even after mediastinal tumor surgery requiring pericardiotomy.</p>

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