Pneumopericardium following severe thoracic trauma

Area of Science:

• Trauma Surgery
• Thoracic Surgery
• Emergency Medicine

Background:

• Traumatic pneumopericardium (PPC) is a rare consequence of chest trauma.
• It arises from pleuropericardial connections, air tracking, or direct trauma.
• Understanding PPC management is crucial for severe thoracic injury outcomes.

Purpose of the Study:

• To outline current management strategies for traumatic pneumopericardium (PPC).
• To identify factors influencing survival in patients with severe thoracic injuries and PPC.
• To analyze operative versus nonoperative treatment approaches.

Main Methods:

• Retrospective analysis of trauma registry data (2015-2022) at a Level I trauma center.
• Inclusion of all patients diagnosed with PPC upon admission.
• Comparison of demographics, injury patterns, and treatments between blunt and penetrating trauma.

Main Results:

• Eighteen patients with PPC were identified among 46,389 trauma admissions.
• The majority (78%) sustained blunt trauma; 89% received tube thoracostomy.
• Most patients (83%) recovered with conservative management; tension PPC required emergent intervention.

Conclusions:

• Traumatic pneumopericardium is a rare finding, often managed successfully with conservative care in an ICU.
• Severe thoracic injuries are common in PPC patients, frequently necessitating thoracostomy.
• Prompt surgical intervention is vital for tension PPC to enhance survival rates.