The Boy Who Lived: Traumatic Hemopericardium in A 12-Year-Old Who Survived Right Atrial Ventricular Groove Rupture, Malpositioned Pericardial Drain and Delayed Surgery

Traumatic cardiac rupture in the pediatric setting is rare and frequently fatal. The management of such patients in resource-limited settings, where cardiothoracic expertise is scarce, poses profound challenges and may ultimately determine survival. We report the case of a 12-year-old boy who presented to a district hospital with hemopericardium following blunt chest trauma. A pericardial drain was promptly inserted but was later found to have malpositioned into the pleural cavity. Definitive surgery was hindered by logistical constraints and limited access to cardiothoracic surgical services. This case underscores the importance of rapid recognition of hemopericardium, careful imaging to confirm pericardial drain placement, and prompt transfer to facilities with cardiothoracic expertise. It also expands the limited literature on pediatric cardiac trauma cases and offers important insights for trauma team in district settings.