2021 Volume 57 Issue 7 Pages 1089-1093
A 14-year-old boy underwent the Nuss procedure owing to pectus excavatum with a Haller index of 4.1. The patient had a favorable postoperative course and was discharged 12 days after the surgery. Chest pain and a sensation of heat appeared in the night on the 35th day after the surgery, and vomiting occurred from the next day. He consulted a nearby doctor, and tachycardia and plain radiography findings indicated cardiac enlargement. He was then admitted to our emergency department with suspected pericarditis. Echocardiography revealed pericardial fluid retention and atrioventricular diastolic dysfunction. He was diagnosed as having cardiac tamponade and underwent pericardial drainage. However, his fever and pericardial fluid retention continued after the drainage. Since no bacteria were identified in a bacterial culture test and there was no deviation in the pectus bar, he was diagnosed as having reactive pericardial effusion. Pectus bar removal was performed 4 days after the drainage. The symptoms improved immediately after removal of the pectus bar, and the patient was discharged 11 days after removal. Although there are some reports of intraoperative cardiovascular damage as a complication of the Nuss procedure, cardiac tamponade due to delayed reactive pericardial effusion is a rare and serious complication. The Nuss procedure should be performed with attention to possible late postoperative complications.
