Sterile Pericarditis Leading To Cardiac Temponade from Intrapericardial Foreign Body 3 Months Following Gunshot Injury to Chest: Syndrome of Acute Intermittent Pericarditis

Patients with bullets in the pericardial sac without myocardial injuries are rare and most commonly are associated with significant trauma. The diagnosis of an intrapericardial foreign body can be difficult. Its removal is always indicated because it prevents pericarditis either sterile or infectious with potential for other significant complications. The syndrome of acute intermittent pericarditis from a foreign body within the pericardium is rarely seen except during time of war. Recently the authors treated a patient with a bullet in the pericardium three month following gunshot injury. During this period the patient developed sterile pericarditis and tamponade which necessitated emergency pericardiectomy and removal of the bullet. This experience and a brief review of the pertinent literature follows.