Cardiac tamponade as a rare complication of pediatric perforated appendicitis

Abstract

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Pericardial disease as a rare complication of pediatric appendicitis: a systematic literature search

“…The one published in 1901 described the use of Ether for their management but did not discuss potential hemodynamic instability of the case. Thus, our own case was the only report that sufficiently described such anesthetic management from a hemodynamic perspective, which underscored the maintenance of spontaneous ventilation with conscious sedation for the emergent pericardiocentesis prior to appendectomy (Table 1) [5].…”

“…Therefore, SIRS secondary to the appendicitis may have been contributory to the pericardial disease. Similarly, in our previous case report, we attributed SIRS secondary to perforated appendicitis as the cause of the cardiac tamponade after ruling out/providing evidence against other likely etiologies which included autoimmune/rheumatologic diseases, malignancy, infection, and trauma [ 5 ]. Additionally, another mechanism contributing to the etiology of pericardial disease may have been the contiguous spread of inflammation and/or infection from the retroperitoneal space to the mediastinum [ 12 – 14 ].…”

“…Three of these articles did not meet the inclusion criteria and a fourth article did meet the inclusion criteria based on the abstract but was not accessible for full-text assessment [6]. The remaining 6 articles [5,[7][8][9][10][11], including our own, encompassed 7 relevant case reports which were used for data synthesis. The cases span across more than a century (119 years) and took place in 6 different countries (Australia, Britain, Canada, Netherlands, Taiwan, Table 1).…”

“…In the majority of cases (5/7), appendicitis was diagnosed before pericardial disease, but in the remaining cases, this order was reversed (Table 1). Only two out of six articles described anesthetic management of a child with a pericardial disease in the context of appendicitis [5,10]. The one published in 1901 described the use of Ether for their management but did not discuss potential hemodynamic instability of the case.…”

“…Pericardial disease, while uncommon, can be a life-threatening condition in the pediatric emergency department and must be identified and treated rapidly to prevent a poor outcome [ 4 ]. Previously, we reported of a unique case with cardiac tamponade complicating perforated appendicitis in a 7-year-old girl [ 5 ] prompting us to investigate the relationship between pericardial disease and pediatric appendicitis further. The main objective of the current study was to explore temporal nature of this relationship.…”