Radiation Pericarditis and Breast Reconstruction: A Surgical Dilemma

ObjectiveTo discuss a case of radiation pericarditis and the physiology of the disease, and to discuss the left thoracotomy as an effective alternative to median sternotomy for pericardiectomy in the treatment of complicated radiation pericarditis.DesignA case report with accompanying discussion of the disease and literature search.SettingKeesler Air Force Base Medical Center, a military training facility and general surgery residency program.ParticipantsA single case report with review of literature.ResultsLeft thoracotomy is an effective alternative to median sternotomy for the surgical treatment of radiation pericarditis, with a mild increase in pulmonary-associated complications.ConclusionsWith an increase in the use of mediastinal radiation for treatment of malignant disease as well as the increase in women having reconstructive procedures of the breast, one may expect complicated cases of radiation pericarditis that may not be amenable to median sternotomy. Left thoracotomy may be an alternative to median sternotomy for pericardiectomy in cases of pericarditis complicated by cosmetic constraints.