RESUMO
Implantation of cardiac devices is usually considered to be a safe procedure. Rare complications, such as pneumothorax, may occur after the procedure. The association with pneumopericardium or pneumomediastinum is even more uncommon. We present the case of a patient in his 70s, on haemodialysis, admitted for complete atrioventricular block. He underwent implantation of a dual-chamber pacemaker. He presented with chest pain the day after implantation. Chest CT scan revealed a pneumothorax associated with a pneumopericardium and pneumomediastinum 'pan pneumo', due to an atrial perforation. We opted for a conservative management strategy. Repeat CT scan of the chest 8 days after the procedure showed a complete resorption of the 'pan pneumo'. The objective of this case report is to describe this rare complication and provide further insight into its management, particularly in the absence of specific guidelines.
Assuntos
Enfisema Mediastínico , Marca-Passo Artificial , Pneumopericárdio , Pneumotórax , Humanos , Marca-Passo Artificial/efeitos adversos , Masculino , Idoso , Pneumotórax/etiologia , Pneumotórax/diagnóstico por imagem , Pneumopericárdio/etiologia , Pneumopericárdio/diagnóstico por imagem , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/diagnóstico por imagem , Bloqueio Atrioventricular/terapia , Bloqueio Atrioventricular/etiologia , Tomografia Computadorizada por Raios X , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/lesões , Dor no Peito/etiologiaAssuntos
Átrios do Coração , Marca-Passo Artificial , Pneumopericárdio , Humanos , Pneumopericárdio/etiologia , Pneumopericárdio/diagnóstico por imagem , Marca-Passo Artificial/efeitos adversos , Átrios do Coração/lesões , Átrios do Coração/diagnóstico por imagem , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/diagnóstico por imagem , Pericárdio/lesões , Pleura/lesões , Pleura/diagnóstico por imagem , Masculino , Idoso , Feminino , Fatores de Tempo , Eletrodos Implantados/efeitos adversosAssuntos
Asma , Enfisema Mediastínico , Pneumopericárdio , Pneumoperitônio , Pneumotórax , Enfisema Subcutâneo , Humanos , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/complicações , Pneumotórax/etiologia , Pneumotórax/complicações , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Pneumoperitônio/etiologia , Pneumoperitônio/complicações , Enfisema Subcutâneo/etiologia , Enfisema Subcutâneo/complicações , Asma/complicações , Doença IatrogênicaRESUMO
A 5 year old boy with acute ly mphoblastic leukaemia on chemotherapy presented with chest pain and vomiting for two days after an elective procedure under general anaesthesia. H is ches t x-ray was remarkabl e for a promin ent halo sign, an air gap surrounding the he art indicat ing a large pneumope ricardium. Alth ough the pneu mo pericardium could not be appre ciated on an echocardiogram, the child developed clinical sig ns of cardiac t amponade. Attem pts to evacu ate the pneumopericardium were unsuccessful leading to death.
Assuntos
Pneumopericárdio , Masculino , Criança , Humanos , Pré-Escolar , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Raios X , Radiografia , Pericárdio , Dor no Peito/etiologiaRESUMO
Nitrous oxide, commonly known as 'laughing gas', has become a popular recreational drug. Whippets, small canisters containing gas in pressurized form, can be easily obtained from a food store. However, inhaling nitrous oxide from these canisters, which contain a 100% concentration, can lead to hypoxia, resulting in seizures or even death. Inhalation of nitrous oxide rarely causes pneumothorax, pneumomediastinum, and pneumopericardium. This case study highlights the potential dangers of recreational abuse of nitrous oxide.
Assuntos
Enfisema Mediastínico , Pneumopericárdio , Pneumotórax , Humanos , Óxido Nitroso/efeitos adversos , Pneumotórax/induzido quimicamente , Pneumotórax/diagnóstico por imagem , Enfisema Mediastínico/induzido quimicamente , Enfisema Mediastínico/diagnóstico por imagem , Pneumopericárdio/induzido quimicamente , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/complicações , Convulsões/induzido quimicamente , Convulsões/complicaçõesAssuntos
COVID-19 , Fístula , Enfisema Mediastínico , Pneumopericárdio , Pneumotórax , Humanos , COVID-19/complicações , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/etiologiaRESUMO
INTRODUCTION: Hemopneumopericardium defines a condition of combined pathology of weakened, dense blood content (hemopericardium) and air (pneumopericardium) in the pericardial cavity with an air fluid level. It is a rare disease, with only one such case reported in the literature. In this case report, we assessed a patient rectal cancer in addition to hemopneumopericardium, dyspnea, and chest pain. CLINICAL CASE REPORT: A 47-year-old Arab woman previously diagnosed with rectal cancer metastasized to bones, lymph nodes, and lungs post-Hartmann procedure reported to the emergency department complaining of worsening dyspnea for 2 weeks, more significantly in the supine position. A productive cough with yellowish sputum characterized this; however, there was no pertinent family or psychological history. Examination of the respiratory system revealed dullness on the left side associated with decreased breath sound. The chest radiograph also revealed marked hydro-pneumopericardium. Spiral computed tomography angiography of pulmonary arteries demonstrated pericardial effusion with the air fluid level at pericardial space, implying hydro-pneumopericardium. CLINICAL CONCLUSION: A successful pericardiocentesis was performed, in which 180 cc of blood-filled pericardial fluid was drained, suggesting the presence of hemopneumopericardium. Hemopneumopericardium has multiple etiologies, yet critical intervention is restricted in patients with cardiac tamponade. Hence, pericardiocentesis could be a definitive treatment.
Assuntos
Tamponamento Cardíaco , Derrame Pericárdico , Pneumopericárdio , Neoplasias Retais , Feminino , Humanos , Pessoa de Meia-Idade , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Derrame Pericárdico/terapia , Tamponamento Cardíaco/etiologia , Dispneia/etiologia , Neoplasias Retais/complicaçõesRESUMO
Pneumopericardium is an exceptionally uncommon phenomenon in the setting of blunt polytrauma. It is imperative for trauma providers to identify tension pneumopericardium despite its rarity. A 22-year-old male motorcyclist presented to the hospital after colliding with a car going approximately 50 mph. The patient was hemodynamically unstable and had diminished breath sounds bilaterally. Bilateral chest tubes were placed, yielding little improvement in condition. While obtaining CT imaging, pneumopericardium was promptly identified. Pulses were lost immediately before pericardiocentesis, and resuscitative thoracotomy was performed. The pericardial sac was tense and an immediate gush of air released upon incising the sac. The patient was taken immediately to the Operating Room for further exploration and repair.
Assuntos
Pneumopericárdio , Traumatismos Torácicos , Ferimentos não Penetrantes , Masculino , Humanos , Adulto Jovem , Adulto , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Choque Cardiogênico , Traumatismos Torácicos/complicações , Pericardiocentese , Ferimentos não Penetrantes/complicaçõesRESUMO
BACKGROUND: Atrial lead perforation may lead to pneumopericardium or pneumothorax within a few days of device implantation. METHODS AND RESULTS: We report a case of atrial lead perforation 6 years after cardiac resynchronization therapy implantation, which resulted in pneumopericardium and pneumothorax. CONCLUSION: Although pneumopericardium caused by atrial lead perforation can spontaneously resolve with conservative treatment, as it did in this case, treatment should be decided based on the patient's general condition and lead performance.
Assuntos
Fibrilação Atrial , Traumatismos Cardíacos , Marca-Passo Artificial , Pneumopericárdio , Pneumotórax , Humanos , Marca-Passo Artificial/efeitos adversos , Fibrilação Atrial/complicações , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Pneumopericárdio/terapia , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Pneumotórax/terapia , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/terapiaRESUMO
Pneumopericardium is the presence of air in the pericardial sac. Pneumopericardium after pericardiocentesis has been rarely reported in the literature. In the present case, we report a patient who presented with tamponade physiology during COVID-19 and developed pneumopericardium after emergency pericardiocentesis. Immediate recognition and treatment are crucial and chest x-ray, thorax computerized tomography, and transthoracic echocardiography (TTE) are used for diagnosis.
Assuntos
COVID-19 , Tamponamento Cardíaco , Pneumopericárdio , Humanos , Pericardiocentese/efeitos adversos , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , COVID-19/complicações , Pericárdio , Tomografia Computadorizada por Raios X , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologiaAssuntos
Diverticulite , Enfisema Mediastínico , Pneumopericárdio , Pneumoperitônio , Retropneumoperitônio , Feminino , Humanos , Idoso , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/etiologia , Retropneumoperitônio/diagnóstico por imagem , Retropneumoperitônio/etiologia , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Pneumoperitônio/diagnóstico por imagem , Pneumoperitônio/etiologiaRESUMO
INTRODUCTION: Tension pneumopericardium is a life-threatening condition, manifesting most commonly as hemodynamic instability caused by cardiac tamponade. Reduced cardiac output and blood pressure can lead to difficulties in the detection of arterial bleeding from associated injuries while the increased venous pressure can increase the rate of bleeding. CASE REPORT: This is the case of a patient after a car accident, with bilateral serial fractures, bilateral pulmonary contusion, bilateral pneumothorax, emphysema of the neck and chest, pneumomediastinum and pneumopericardium, and other injuries. During treatment, the patient developed a gradually progressing hemodynamic instability, resulting in pulseless electrical activity. Further progression of the case is detailed in the paper. CONCLUSIONS: Tension pneumopericardium is a rare complication of a high-energy blunt thoracic trauma that manifests through hemodynamic instability. Its treatment requires early diagnosis and immediate decompression of the pericardial cavity, which should, where possible, be performed even before putting the patient on mechanical ventilation as ventilation bears a high risk of worsening the pneumopericardium due to the increased air pressure in the lungs. During diagnosis and treatment of associated injuries, we must bear in mind that the hemodynamic changes caused by pneumopericardium can mask typical signs of such injuries.
Assuntos
Traumatismo Múltiplo , Pneumopericárdio , Pneumotórax , Traumatismos Torácicos , Humanos , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Traumatismos Torácicos/complicações , Pneumotórax/terapia , Traumatismo Múltiplo/complicações , Respiração Artificial/efeitos adversosAssuntos
Carcinoma de Células Escamosas , Neoplasias Pulmonares , Pneumopericárdio , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Células Epiteliais/patologia , Humanos , Pulmão , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Tomografia Computadorizada por Raios XRESUMO
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.
Assuntos
Doenças do Cão , Hérnia Diafragmática , Pneumopericárdio , Animais , Cães , Diafragma , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Hérnia Diafragmática/diagnóstico por imagem , Hérnia Diafragmática/cirurgia , Hérnia Diafragmática/veterinária , Pericárdio , Pneumopericárdio/diagnóstico por imagem , Pneumopericárdio/etiologia , Pneumopericárdio/veterináriaRESUMO
Spontaneous pneumothorax leading to pneumomediastinum, pneumopericardium and surgical emphysema is a benign condition. Progression to the development of epidural pneumatosis is rare. We report a 19-year-old man who presented with dyspnoea and swelling of the chest wall following a bout of cough. Bilateral subcutaneous emphysema was palpated on the anterior chest wall from the sternum to the midaxillary regions. His chest X-ray revealed subcutaneous emphysema and pneumopericardium. His computed tomography of the thorax to rule out life-threatening conditions revealed bilateral subcutaneous emphysema, pneumomediastinum, pneumo-pericardium and pneumothorax. He was transferred to the intensive care unit. An intercostal drainage tube was inserted in the left pleural cavity. The patient was followed up with repeat chest X-rays. The patient's symptom got relieved and was discharged after day 9. Diagnosis of pneumomedia-stinum may not be as lamentable as it is seen. Close cardio-pulmonary monitoring is mandatory for complications and accompanying conditions. Most patients with uncomplicated spontaneous pneumomediastinum respond well to oxygen and conservative management. In this case, the patient's symptoms and severe tachypnoea prompted the insertion of an intercostal drainage tube.