Pneumopericardium in the Neonate.

Pneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates.

Gastric perforation into the pericardium.

Gastric perforation into the pericardium is an extremely rare but lethal condition. Only a few case reports have been described in the literature. It is difficult to diagnose these patients with clinical evaluation. Accurate and immediate diagnosis of the intestinal perforation is vital. Herein, we present a 56-year old female patient with gastric perforation into the pericardium due to benign gastric ulcer diagnosed with computed tomography (CT). We also emphasized the imaging findings in the diagnosis of intestinal perforation into the pericardium.

Neumopericardio en un paciente con carcinoma de pulmón / Pneumopericardium in a patient with lung carcinoma

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Iatrogenic Pneumopericardium After Pericardiocentesis.

A 65-year-old patient underwent pericardiocentesis for cardiac tamponade after radiofrequency ablation for ventricular tachycardia. Subsequent to stabilization, the patient developed pneumopericardium, which was detected in the catheterization laboratory and managed successfully by pericardial aspiration.

Intraoperative occurrence of a pneumopericardium during double-lung transplantation.

Pneumopericardium is rare and has been reported secondary to chest trauma. We report a case of tension pneumopericardium occurring during double-lung transplantation, where intraoperative transoesophageal echocardiography first showed a hypokinetic left ventricle and a few minutes later a compression of its anterolateral portion due to pneumopericardium. Although the pericardium was opened, left ventricular function remained depressed, necessitating extracorporeal membrane oxygenation, which was withdrawn after 48 h of assistance when left ventricular function had recovered. The patient was extubated on the seventh postoperative day but died of multiorgan failure on the 64 th postoperative day.

Pericardial diseases.

The pericardium provides an enclosed lubricated space for the beating heart and functions to fix the heart in the chest cavity relative to adjacent organs. Pericardial pathophysiology is often manifested in a spectrum of distinct cardiac and systemic disease states. The pericardial response to injury typically involves a spectrum of inflammation with both acute and chronic features and/or fluid accumulation. Recent advances in imaging methods have refined the diagnosis and therapy of pericardial disease. This article presents the anatomy and physiology of pericardial disease and the clinical approach for diagnosis and treatment.

Neumopericardio tardío tras pericardiocentesis / Late pneumopericardium after pericardiocentesis

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[Pneumopericardium after hyperemesis. Possible result of the Macklin effect]. / Pneumoperikard nach Hyperemesis. Eine Folge des Macklin-Effektes?

Pneumopericardium is a rare but serious finding. It may indicate severe chest trauma and be associated with tracheobronchial and oesophageal injuries. On the other hand, oesophageal rupture such as Boerhaave's syndrome may also be accompanied by pneumopericardium. A case of spontaneous pneumopericardium and pneumomediastinum after alcohol-induced emesis is reported. Tracheal, bronchial, and oesophageal injury were excluded by radiology and endoscopy. Interstitial lung emphysema is discussed as the pathogenesis.