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Related Experiment Videos

Benign pneumopericardium and tamponade

T Hadjis1, D Palisaitis, L Dontigny

  • 1Department of Cardiology, Hôpital du Sacré-Coeur, Université de Montéal, Québec.

The Canadian Journal of Cardiology
|March 1, 1995
PubMed
Summary
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This case report details a rare instance of a perforated gastric ulcer causing tension pyopneumopericardium. Immediate treatment was successful, but the patient later died from pulmonary embolism and bleeding, highlighting elevated postoperative mortality risks.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Thoracic Surgery

Background:

  • A 49-year-old obese female with a history of esophageal surgery presented with acute pleuritic chest pain.
  • Initial echocardiography identified a pericardial effusion, which responded to steroid treatment.

Observation:

  • Recurrent symptoms led to examination revealing cardiac tamponade and a Hammond crunch.
  • Chest X-ray demonstrated pneumopericardium, indicating air in the pericardial sac.
  • Intraoperative findings included an intrathoracic stomach with a perforated greater curvature ulcer, mediastinal abscess, and pericardial involvement.

Findings:

  • Surgical intervention involved creating a pericardial window, placing a drain, and repairing the perforated ulcer.
  • Postoperative complications included fever and gastrointestinal bleeding.

Related Experiment Videos

  • Autopsy revealed massive pulmonary embolism, a bleeding esophageal ulcer, a healed gastric ulcer, and serofibrinous pericarditis.

    • Implications:

    • This case highlights the critical, albeit often temporary, success of immediate interventions for tension pyopneumopericardium.
    • Despite successful acute management, significant postoperative mortality persists due to complications like pulmonary embolism and bleeding.
    • The complex interplay between gastrointestinal pathology and cardiac complications underscores the need for comprehensive patient assessment and management.