Radiation pericarditis and breast reconstruction: a surgical dilemma.

OBJECTIVE: To 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.

DESIGN: A case report with accompanying discussion of the disease and literature search.

SETTING: Keesler Air Force Base Medical Center, a military training facility and general surgery residency program.

PARTICIPANTS: A single case report with review of literature.

RESULTS: Left thoracotomy is an effective alternative to median sternotomy for the surgical treatment of radiation pericarditis, with a mild increase in pulmonary-associated complications.

CONCLUSIONS: With 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.