Isolated pneumopericardium in a preterm neonate with respiratory distress syndrome: A case report

Neonatal pneumopericardium is a rare neonatal air leak syndrome often associated with mechanical ventilation and respiratory distress syndrome (RDS). It occurs when alveolar rupture permits air to enter the pericardial sac. Although it can lead to severe complications such as cardiac tamponade, some cases remain hemodynamically stable and resolve spontaneously without invasive intervention. We report a premature infant (31 + 5 weeks gestation) with RDS who developed an isolated pneumopericardium, presenting with sudden respiratory deterioration but no hemodynamic instability. Diagnosis was confirmed radiographically, and the condition resolved with conservative management, including ventilatory adjustments. This report highlights the importance of early recognition and tailored respiratory management to mitigate the complications of pneumopericardium, while emphasizing areas for future research on optimal ventilatory strategies and non-invasive surfactant delivery techniques.