Spontaneous Pneumopericardium in Acute Asthma: Case Report and Review of the Literature

Spontaneous Pneumopericardium: Case Report and Review of the Literature

“…Histological preparations have demonstrated a site of potential weak ness where the parietal pericardium is re flected on the visceral pericardium near the ostia of the pulmonary veins [6]. The same mechanism was elucidated by recent reports where spontaneous pneumopericardium complicated acute asthma [3], prolonged la bor [15], and even cocaine inhalation by a special positive pressure sniffing technique [16].…”

“…The cases described in the literature were classified as: (1) Iatrogenic -examples in clude thoracocentesis, poststemal bone mar row aspiration, postcauterization of esopha geal webs, after an esophago-antrostomy and complicating endotracheal intubation [3,4], However, most cases occurred in preterm newborn infants treated with positive pres sure ventilation for idiopathic respiratory distress syndrome [5,6], (2) Trauma, pene trating or blunt, including foreign body aspi ration [7,8], (3) Pericarditis with formation of pneumopyopericardium, where produc tion of gas is caused by gas-forming organ isms. It can also occur with direct extension of the inflammatory process from adjacent structures, particularly air-filled organs, e.g.…”

“…[9][10][11][12], (4) Fistula formation be tween the pericardium and air-containing structures such as the gastrointestinal tract, the pleural cavity and the bronchial tree. Examples include esophageal and gastric ul cer, achalasia, esophageal and gastric carci noma, esophageal diverticulum, histoplas mosis, tuberculosis and bronchogenic carci noma [3,13,14],…”

“…The chest roentgenogram confirms the diagnosis. The gas does not rise above the upper limit of the pericardium in the erect position, differen tiating pneumopericardium from pneumo thorax or pneumomediastinum [3,13]. In the presence of normal findings in the chest, one has to search for the cause in the abdo men.…”

Pneumomediastinum and Pneumopericardium in an 11-Year-Old Rugby Player: A Case Report

“…[1][2][3] Pericardial connective tissue is discontinuous at the lines of reflection of the parietal pericardium near the ostia of the pulmonary veins, creating a site of potential weakness where microscopic dissection of air into the pericardial sac is possible. 1,2,[4][5][6] Pneumomediastinum can be spontaneous, occurring without an evident primary cause, or secondary to underlying and predisposing conditions, such as asthma, bronchiolitis obliterans, tobacco smoke, illegal drug ingestion, or blunt thoracic trauma. In the case of trauma, PM is more serious due to the likely association with other injuries and the higher risk of complications.…”