Early Pneumopericardium after Endoscopic Thoracic Sympathectomy

Pneumopericardium is a condition characterised by the presence of air within the pericardium. We hereby present a case of a rare potentially life-threatening complication, which is, to our knowledge, the first report of the pneumopericardium after single port endoscopic thoracic sympathectomy (SPETS). A 25-year male patient with a history of bilateral palmar hyperhidrosis underwent SPETS. Routine chest X-ray at post-anesthesia care unit showed presence of diffuse subcutaneous emphysema, helping to establish the diagnosis of pneumopericardium with no symptoms after the surgery.  Pneumopericardium should be considered among the possible complications of SPETS. Such complication may progress to a fatal event, if not recognised early and managed rapidly. Based on clinical experience, routine postoperative clinical follow-up protocols should be established and applied for each patient following SPETS. Key Words: Palmar hyperhidrosis, Endoscopic thoracic sympathectomy, Pneumopericardium.