Pneumopericardium due to bronchopericardial fistula in a patient with lung cancer

Lages, Joana; Oliveira, Cátia; Lacerda, Catarina

doi:10.1136/bcr-2018-226939

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…Most cases revolve around solid malignancies located in either the lung or esophagus, with the exception of 2 cases, one related to acute lymphoblastic leukemia and another to NK/T-cell lymphoma. Similar to our case, dyspnea was the most common presenting symptom along with chest pain [7][8][9]. Other common presentation symptoms included cough, fever, weight loss, and hemoptysis [9][10][11].…”

Section: Discussionsupporting

confidence: 82%

“…It is fundamental to include the prognosis of the disease and functional status, when generating a management plan. Our case presents pneumopericardium in a patient with advanced gastroesophageal junction tumor with no concerns for tamponade and hemodynamic stability that was treated appropriately with conservative measures and palliative treatment like other cases with advanced cancers and poor performance status [9,18].…”

Section: Discussionmentioning

confidence: 92%

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Cancer-Related Pneumopericardium: A Case Report and Literature Review

Hirani¹,

Martinez²,

Patan³

et al. 2020

Case Rep Oncol

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Pneumopericardium is a relatively rare entity mostly described in the literature as a result of causes such as penetrating/blunt trauma and iatrogenic causes during cardiothoracic procedures. We are presenting a case of pneumopericardium as a complication of progressed gastroesophageal junction tumor along with a literature review of all cancer-related pneumopericardium cases reported in the last decade. We present the case of a 65-year-old male with a past medical history significant for locally advanced gastroesophageal junction adenocarcinoma who presented to the hospital with complaints of shortness of breath and fever. A chest X-ray showed an intact esophageal stent along with radiolucency around the cardiac silhouette which suggested pneumopericardium. Computed tomography scan of the chest confirmed the presence of pneumopericardium in posterior pericardium with foci of gas above the esophageal stent likely to be communicating with the pericardium. An echocardiogram was obtained which showed no signs of tamponade. Given the advanced nature of the disease we applied a conservative management given that the pneumopericardium was deemed to be small with no tamponade. Goals of care were discussed with the patient and his family and the patient opted for comfort care measures. This case report prompted us to perform an extensive literature review of cancer-related pneumopericardium from 2008 to 2019. We found 11 cases where it was reported secondary to malignancies of different kinds. Our aim is to compile a review for clinicians to view varied presentations and better direct therapy dependent on the individual case and clinical presentation in patients with cancerrelated pneumopericardium. Moreover, although pneumopericardium is rare, it should be considered in differential diagnosis in patients presenting with shortness of breath or chest pain especially with cancers involving the cardiothoracic region.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 92%

Cancer-Related Pneumopericardium: A Case Report and Literature Review

Hirani¹,

Martinez²,

Patan³

et al. 2020

Case Rep Oncol

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“… 1 Described cases of pneumopericardium in patients with lung cancer are extremely rare, with very few cases in the literature. 2 In this clinical case, the existence of the pneumopericardium was due to a direct pleuro-pericardial communication. On both thoracic radiographs and CT, the diagnosis is established by the presence of a paracardiac radiotransparent band that separates the pericardium from the heart, called ‘continuous diaphragm sign’.…”

mentioning

confidence: 68%

Spontaneous pneumopericardium in a patient with lung cancer

Campos

Azevedo

Fernandes

et al. 2020

European Heart Journal - Case Reports

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“…The pneumopericardium seen in our case is likely due to a leaky drainage system, rather than a pleuro-pericardial communication, leading to the entrance of air into the pericardial sac. Patients with a puncture or fistulous tract-related pneumopericardium commonly develop life-threatening complications as well as evidence of recurrent pneumopericardium despite repeat manual evacuation of air from the pericardial sac [ 6 , 7 ]. If a leaky drainage system is suspected as a potential cause of pneumopericardium, immediate recognition and treatment of this rare complication are essential.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to our case, when there is evidence of a tension pneumopericardium, patient management should strive for pericardial decompression. The removal of excess air can be performed by pericardiocentesis or incision and drainage of the pericardial sac [ 7 ]. Once pericardial decompression is achieved, replacement of the leaky drainage system and prompt bedside echocardiography are essential to avoid repeat iatrogenic complications.…”

Section: Discussionmentioning

confidence: 99%

Complicated Iatrogenic Pneumopericardium in a Patient With Suspected Multiple Myeloma

López¹,

Blanco²,

Rodríguez³

et al. 2022

Cureus

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Pneumopericardium is the presence of air within the pericardial cavity. Though several etiologies and pathological mechanisms for this have been described, there is no clear consensus. Most resolve spontaneously, but others may develop severe complications such as cardiac tamponade which may lead to cardiorespiratory arrest. We report a rare case of a patient who developed a tension pneumopericardium requiring emergent aspiration following a therapeutic pericardiocentesis. Radiological and echocardiographic findings of this rare iatrogenic pneumopericardium are reviewed.

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Pneumopericardium due to bronchopericardial fistula in a patient with lung cancer

Cited by 7 publications

References 3 publications

Cancer-Related Pneumopericardium: A Case Report and Literature Review

Cancer-Related Pneumopericardium: A Case Report and Literature Review

Spontaneous pneumopericardium in a patient with lung cancer

Complicated Iatrogenic Pneumopericardium in a Patient With Suspected Multiple Myeloma

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