Spontaneous pneumopericardium.

Abstract

. (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

Spontaneous Subcutaneous Emphysema with Pneumo-Mediastinum: A Case Report

“…The chest evaluation demonstrated symmetrical and bilateral clear breath sounds and normal heart sounds without any murmur but mediastinal crunch was audible on auscultation. These findings were also matching with the findings in a study by Gossage AR et al [9] and Walsh-Kelly C [10]. As fever was the initial presentation along with increased WBC count in our case, the findings of the study done by Ralph-Edwards C were also supporting our case study [11].…”

A Case of Spontaneous Pneumomediastinum and Pneumopericardium in a Young Adult

“…They may experience dyspnea, dysphagia, neck and throat pain or dysphonia. Physical examination may show respiratory distress, neck crepitus, decreased cardiac dullness, Hamman’s sign (a mediastinal crunching sound that is synchronized with systole) or, rarely, signs of pericardial tamponade 14 , 15 ) . Low grade fever is present in about one-third and mild leukocytosis in about one-half of cases 16 ) .…”

Spontaneous pneumomediastinum and pneumopericardium in a young healthy adult with plans for air travel

“…Other cases of isolated pneumopericardium published have been related to perforated gastric ulcers, but this young man had no symptoms or signs suggestive of this. 1 A potentially life-threatening sequelae of free air in the pericardial space is tension pneumopericardium resulting in tamponade; however, the patient remained hemodynamically stable with no clinical evidence of this, and so, no echocardiogram was performed.…”