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pneumopericardium
air in the pericardial cavity
Etiology:
- trauma (most common)
- fistula between pericardium &
- pleural space
- pulmonary alveoli
- bronchial tree
- gastrointestinal tract
- gas produced by microorganisms invading the pericardial sac
- Clostridium perfringens
- Klebsiella
Epidemiology:
- rare
Clinical manifestations:
- 'mill wheel' murmur
- shifting tympany - observed with precordium percussion in recumbent & upright positions
Special laboratory:
- electrocardiogram: see pericarditis
- echocardiogram may reveal cardiac tamponade if present
Radiology:
- chest X-ray may be helpful
- computed tomography shows pericardial air
- barium swallow may show esophageal fistula
Management:
- consult cardiology
- if signs of cardiac tamponade
- pericardiocentesis
- pericardial catheter should be left in place to prevent recurrence
General
pericardial disease
pneumothorax
References
- Wikipedia: Pneumopericardium
http://en.wikipedia.org/wiki/Pneumopericardium
- GP Notebook: Pneumopericardium
http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20040810110502112940
- Radiopaedia: Pneumopericardium
http://radiopaedia.org/articles/pneumopericardium