Spontaneous pneumopericardium in a dog with bronchopulmonary disease complicated by pyothorax and pneumothorax.

Spontaneous pneumopericardium is a rare condition consisting of pericardial gas in the absence of iatrogenic or traumatic causes; it has been described secondary to pneumonia, lung abscess, and bronchopulmonary disease. This report describes a case of spontaneous pneumopericardium in a dog presenting with dyspnea secondary to pyopneumothorax complicating a bronchopulmonary disease.

Pneumopéricarde spontané chez un chien avec une maladie broncho-pulmonaire compliquée par la pleurésie et le pneumothorax. Un pneumopéricarde spontané est une rare affection qui cause des gaz péricardiques en l'absence de causes iatrogéniques ou traumatiques; il a été décrit comme secondaire à la pneumonie, à un abcès pulmonaire et à la maladie broncho-pulmonaire. Ce rapport décrit un cas de pneumopéricarde spontané chez un chien présenté avec une dyspnée secondaire au pyopneumothorax compliquant une maladie broncho-pulmonaire.(Traduit par Isabelle Vallières).

Pneumopericardium after peritoneopericardial diaphragmatic hernia repair in a dog.

A one-year-old neutered, Goldendoodle presented for evaluation. One week prior to presentation, the surgical closure of a peritoneopericardial diaphragmatic hernia was performed via ventral midline celiotomy. Since the procedure, the dog had been lethargic and anorexic at home. Thoracic radiographs revealed a pneumopericardium. Pericardiocentesis was performed which evacuated approximately 100 mL of air from the pericardial sac. The dog recovered well and began eating in the hospital and resumed normal activity. This is the first reported case of a pneumopericardium post-peritoneopericardial diaphragmatic hernia repair requiring pericardiocentesis. Clinicians should be aware of this rare complication in patients with post-operative peritoneopericardial diaphragmatic hernia.

Septic pericarditis and pneumopericardium in a dog with an oesophageal foreign body.

A 5-year-old, intact, male Yorkshire Terrier presented with a 6-day history of lethargy and anorexia. Clinical examination revealed dental plaque accumulation, abdominal effort during respiration and muffled heart sounds. Thoracic radiographs revealed an enlarged globoid cardiac silhouette and mild pneumopericardium, transthoracic ultrasonography revealed a pericardial effusion after which pericardiocentesis, cytology and culture diagnosed septic pericarditis. Three multidrug-resistant bacteria were isolated, two of which have been implicated in gas-producing infections before. Medical management failed to resolve the pericarditis and euthanasia was opted for. A chronic osseocartilaginous oesophageal foreign body cranial to the heart base was found on necropsy. Septic pericarditis and pneumopericardium are rare conditions in dogs. This is the first case to describe a multidrug-resistant polybacterial aetiology causing mild pneumopericardium and only the second case to describe septic pericarditis associated with an oesophageal foreign body.

Pneumopericardium Secondary to Pneumomediastinum in a Golden Retriever Dog.

Pneumopericardium is a rare finding that has been previously reported following spontaneous, traumatic, or iatrogenic causes. A 3-year old Golden Retriever dog was admitted with respiratory distress after falling from a height. Clinical and electrocardiographic findings were nonspecific. Thoracic radiography revealed hyperinflated lung with sharp outlining of the mediastinal structures. A well-demarcated region of radiolucent gas opacity was seen surrounding the cardiac silhouette. Echocardiography revealed intense hyper-reflective shadows all over the heart. Echocardiographic measurements were within the reference range. The dog responded well to conservative medical therapy. Pneumopericardium was reported secondary to pneumomediastinum; pneumopericardium is self-limiting unless other complications develop.

Pneumopericardium, pneumomediastinum, pneumothorax and pneumoretroperitoneum complicating pulmonary metastatic carcinoma in a cat.

This report describes a case of severe spontaneous tension pneumopericardium with concurrent pneumomediastinum, pneumothorax and retropneumoperitoneum in a cat presenting with dyspnoea and signs of cardiac tamponade secondary to metastatic pulmonary carcinoma. Spontaneous pneumopericardium is an extremely uncommon condition consisting of pericardial gas in the absence of iatrogenic/traumatic causes. In humans, it has been described secondary to pneumonia or lung abscess and very rarely secondary to pulmonary neoplasia.

Hemodynamics of progressive pneumopericardium in the dog.

The hemodynamics of progressive pneumopericardium were studied in 6 anesthetized healthy dogs (with intact thorax). Heart rate, cardiac output, and pericardial and intravascular pressures were recorded. Pressures were measured in the pericardial space by means of a percutaneously introduced, air-filled catheter, and in the right atrium, right ventricle, left atrium, left ventricle, pulmonary artery, and aorta by means of fluid-filled catheters. The gradual increase in mean pericardial pressure up to 11 +/- 2 mm of Hg was associated with increases in heart rate and mean right atrial, mean left atrial, right ventricular end-diastolic, and left ventricular end-diastolic pressures and with decreases in cardiac output and stroke volume, with no change in left ventricular systolic and mean aortic pressures. Critical cardiac tamponade occurred at a pericardial pressure of 12.2 +/- 2.8 mm of Hg, which was produced by 8.7 +/- 1.9 cm3 air/kg of body weight. This was characterized by a sudden marked decrease in heart rate, cardiac output, stroke volume, left ventricular systolic pressure, and mean aortic pressure, and equilibration of mean right atrial, mean left atrial, right ventricular end-diastolic, left ventricular end-diastolic, and pulmonary artery diastolic pressures. These hemodynamic changes were similar to those of experimental pericardial effusion.

Subcutaneous emphysema, pneumothorax, pneumomediastinum, and pneumopericardium associated with positive-pressure ventilation in a cat.

Subcutaneous emphysema, pneumothorax, pneumomediastinum, and pneumopericardium with hypotension and tachycardia were observed after endotracheal intubation and during positive-pressure ventilation in a previously healthy cat anesthetized for ovariohysterectomy. Potential causes included tracheal tearing during intubation, a closed pop-off valve while using high oxygen flows, and preexisting acquired or congenital abnormalities in the respiratory tract. The cat responded well to conservative management, including cessation of positive-pressure ventilation and use of increased inspired oxygen concentration.

Pneumopericardium associated with a pulmonary-pericardial communication in a dog.

A 6-year-old 18-kg (39-lb) spayed female Standard Poodle was referred for treatment of pneumopericardium. The dog did not have severe clinical signs relating to the pneumopericardium, and the diagnosis was made incidentally while investigating the cause of a cough. Computed tomography revealed an air-filled structure consistent with a bulla to the right of the heart base that appeared to communicate with the pericardial cavity Because spontaneous resolution of the pneumopericardium seemed unlikely and cardiac tamponade was a possibility, exploratory thoracotomy was performed. A lobulated bulla was found at the hilus of the right middle lung lobe adhered to the underlying pericardial sac, and a 4-cm-diameter communication from the pericardium to the pulmonary bulla was found. Right middle lung lobectomy was performed, and the pericardiotomy and pericardial opening were sutured. The dog recovered without complications. In previously reported cases of pneumopericardium involving a cat and a dog, the condition resolved spontaneously. In this dog, in contrast, surgical resection of the affected lung lobe with pericardial reconstruction was required for resolution of the pneumopericardium.