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Tension pneumopericardium: case report.
Patrick Macgoey1, Markus Schamm, Elias Degiannis
1Trauma Unit, Chris Hani Baragwanath Hospital, Johannesburg, Republic of South Africa. macgoey@doctors.org.uk
Summary
Pneumopericardium, air in the pericardial sac, can cause rapid cardiac arrest. Emergent drainage via sub-xiphoid pericardial window is a life-saving bedside procedure for tension pneumopericardium.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Cardiology
Background:
- Pneumopericardium, air in the pericardial space, is a rare complication of chest trauma or iatrogenic causes.
- It can be classified as 'simple' or 'tension' pneumopericardium, with the latter causing circulatory compromise.
Observation:
- This case report details a multiply injured trauma patient who experienced rapid deterioration to cardiac arrest due to pneumopericardium.
- Radiological confirmation of pneumopericardium was established.
Findings:
- Tension pneumopericardium necessitates immediate pericardial sac drainage to prevent cardiac arrest.
- Open drainage using a sub-xiphoid pericardial window, performed at the bedside, proved effective in restoring spontaneous circulation.
Implications:
- The sub-xiphoid pericardial window technique is advocated as a rapid and effective method for emergent drainage of pneumopericardium.
- Prompt recognition and intervention are crucial for managing this life-threatening condition and improving patient outcomes.
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