• Magdy Giurgius, Fahad Al Asfar, Piyaray M Dhar, and Nema Al Awadi.
• Department of Surgery, Al-Adan Hospital, Ministry of Health, Kuwait. magdy_gis@yahoo.com
• Med Princ Pract. 2006 Jan 1;15(1):80-2.

ObjectivesTo report a case of penetrating cardiac injury with patient's survival.Clinical Presentation And InterventionA 23-year-old man stabbed with a knife to the epigastric area just below the right costal margin was brought to the Emergency Room, Al-Adan Hospital, Kuwait, in a state of shock. Aggressive resuscitation was performed, chest X-ray showed no evidence of hemo- or pneumothorax. Exploratory laparotomy was performed revealing a severely congested liver, with no intraperitoneal hemorrhage to explain his being in a state of shock. Left thoracotomy revealed pericardial tamponade with perforation in the right ventricle and hemorrhage. A mattress suture was used to control bleeding from the right ventricle. Postoperative echography revealed a tear in the interventricular septum and papillary muscle. Open-heart surgery was performed to repair the injured tissues. The patient made an uneventful recovery.ConclusionThis report shows that patients with penetrating cardiac injuries and detectable vital signs on arrival at the hospital can be salvaged by prompt surgical intervention.

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