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. 2011 May;41(5):280-2.
doi: 10.4070/kcj.2011.41.5.280. Epub 2011 May 31.

Pneumopericardium as a complication of pericardiocentesis

Woo Hyung Choi  1 , You Mi Hwang, Mi Youn Park, Seung Jae Lee, Hye Yeon Lee, Sei Won Kim, Byoung Yeon Jun, Jin Soo Min, Woo Seung Shin, Jong Min Lee, Yoon Seok Koh, Hui-Kyung Jeon, Wook Sung Chung, Ki-Bae Seung
Affiliations

Pneumopericardium as a complication of pericardiocentesis

Woo Hyung Choi et al. Korean Circ J. 2011 May.

Abstract

Pneumopericardium is a rare complication of pericardiocentesis, occurring either as a result of direct pleuro-pericardial communication or a leaky drainage system. Air-fluid level surrounding the heart shadow within the pericardium on a chest X-ray is an early observation at diagnosis. This clinical measurement and process is variable, depending on the hemodynamic status of the patient. The development of a cardiac tamponade is a serious complication, necessitating prompt recognition and treatment. We recently observed a case of pneumopericardium after a therapeutic pericardiocentesis in a 20-year-old man with tuberculous pericardial effusion.

Keywords: Pericardiocentesis; Pneumopericardium.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Chest X-ray on admission showed cardiomegaly with a clear lung.
Fig. 2
Fig. 2
Two-dimensional echocardiography showed extensive pericardial effusion. LV: left ventricle, LA: left atrium, RV: right ventricle, RA: right atrium, PE: pericardial effusion.
Fig. 3
Fig. 3
On day 5, Lucent outline (→) representing the pericardial sac around the heart with clear lung is shown as an image above. Meanwhile, air (*) surrounding the cardiac boarder and air-fluid level (↑) in the pericardial space is also noted. The pericardial drainage catheter (←) has been placed into a loculated effusion using an subxiphoid approach.
Fig. 4
Fig. 4
Follow up two-dimensional echocardiography showed multiple bright echogenic spots (white arrow) swirling in the pericardial cavity.
Fig. 5
Fig. 5
On day 10, a chest X-ray showed the regression of pericardial air after conservative treatment.
See this image and copyright information in PMC

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