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Development of massive pneumopericardium after intubation and positive pressure ventilation

Ali S Wahla1, Fahim Zaman Khan

  • 1Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore. alis@skm.org.pk

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|May 29, 2012
PubMed

Insights

Pneumopericardium, a rare condition, can occur after mechanical ventilation or pneumonia. This case highlights its development in a child with leukemia following intubation for a procedure.

Area of Science:

  • Medicine
  • Critical Care Medicine
  • Pediatric Oncology

Background:

  • Pneumopericardium is an uncommon complication associated with chest trauma, mechanical ventilation, and cavitating pneumonia.
  • Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm that affects myeloid cells.

Observation:

  • A 7-year-old patient with chronic myeloid leukemia (CML) presented with ongoing Enterococcal pneumonia.
  • The patient developed massive pneumopericardium immediately after elective intubation for a diagnostic radiological procedure.

Findings:

  • This case demonstrates a rare instance of pneumopericardium developing rapidly post-intubation in a pediatric patient with CML and pneumonia.
  • The rapid onset suggests a potential link between the intubation procedure and the development of pneumopericardium in this specific clinical context.

Implications:

  • Increased prevalence of intensive care medicine necessitates heightened awareness of rare but critical conditions like pneumopericardium.
  • Clinicians should consider pneumopericardium in the differential diagnosis for patients presenting with respiratory distress or hemodynamic instability, especially after procedures involving airway manipulation.
  • Early recognition and management of pneumopericardium are crucial for improving patient outcomes in critical care settings.

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