. (1976). Thorax, 31,[460][461][462][463][464][465]. Spontaneous pneumopericardium. Spontaneous pneumopericardium is a relatively rare event, although cases have been recorded over the past 130 years. Many were associated with malignancy, trauma, infection or as a complication of recent surgery. Attempts at surgical resolution have been infrequent and survival extremely rare. We describe a patient in whom pneumopericardium developed spontaneously and insidiously, probably being present for some weeks before hospital investigation. Surgical exploration revealed the cause to be a benign gastric ulcer without an hiatus hernia or other diaphragmatic defect. Repair was attempted but the patient died in the early postoperative period. From an extensive review of the literature it is clear that spontaneous perforation of a gastric ulcer into the pericardium must be less rare than some authors have suggested.The credit for identification of the first case of pneumopericardium is ascribed by some authors to Bricketeau (1844), who proved his diagnosis post mortem. There had been earlier descriptions but the details are not recorded. Bricketeau also described the loud metallic sound of water being splashed in a closed cavity containing air, the
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