Isolated pneumopericardium caused by positive pressure ventilation: A rare complication

Bhakta, Pradipta; McNamara, John R.; O’Brien, Brian; Plant, Robert

doi:10.1016/j.jclinane.2018.05.016

Cited by 2 publications

(2 citation statements)

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“…1 However, iatrogenic pneumopericardium is typically self-limited, resolves spontaneously, and does not often necessitate intervention. 2,7 The diagnosis of pneumopericardium is made by chest radiography. Pneumopericardium can be differentiated from pneumomediastinum on radiography by gas sharply demarcating the pericardial sac around the left ventricle and right atrium (Image 2).…”

Section: Discussionmentioning

confidence: 99%

“…1 Rare cases have been observed with mechanical ventilation in difficult to ventilate patients, after using high peak airway and positive end expiratory pressures. 2 While rare, pneumopericardium has been documented after laparoscopy and is thought to occur as gas dissects from the peritoneum into the mediastinum and pericardium via the diaphragmatic hiatus. 3,4,5 Electrocardiogram (ECG) changes including ST-segment depressions have been described in cases of pneumopericardium.…”

Section: Introductionmentioning

confidence: 99%

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Pneumopericardium after Laparoscopic Hernia Repair Presents with ST-segment Changes: A Case Report

Galindo

Martin

Franzen

2021

Clinical Practice and Cases in Emergency Medicine

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Introduction: Although rare, iatrogenic cases of pneumopericardium have been documented following laparoscopic surgery and mechanical ventilation. Electrocardiogram (ECG) changes, including ST-segment depressions and T-wave inversions, have been documented in cases of pneumopericardium, and can mimic more concerning causes of chest pain including myocardial ischemia or pulmonary embolism. Case Report: This unique case describes a patient who presented with chest pain and ST-segment changes on ECG hours after a laparoscopic inguinal hernia repair and who was found to have pneumopericardium. Conclusion: While iatrogenic pneumopericardium is often self-limiting and rarely requires intervention, it is critical to differentiate pneumopericardium from other etiologies of chest pain, including myocardial ischemia and pulmonary embolism, to prevent unnecessary intervention.

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Section: Discussionmentioning

confidence: 99%