Uluçam Melek Zekiye
Cardiology Department, Baskent University School of Medicine, Ankara, Turkey,
Cardiol Ther. 2013 Jun;2(1):103-10. doi: 10.1007/s40119-012-0008-6. Epub 2012 Dec 1.
Pneumopericardium, an accumulation of air in the pericardial cavity, occurs very rarely as compared to pneumothorax and pneumomediastinum. Clinical presentation is variable, patients are frequently asymptomatic, and mild cases usually resolve spontaneously. However, it may lead to pericardial tamponade, which requires rapid diagnosis and treatment that can be lifesaving. The traditional diagnostic, simple method of diagnosis is via an upright chest X-ray. Typical findings can be detected and a differential diagnosis can be made between pneumomediastinum and pneumopericardium. Echocardiography and chest computed tomography scans can also support the diagnosis. Only one case of pneumopericardium after surgical pericardiotomy has been reported in the literature so far. In this case report, iatrogenic pneumopericardium, which resolved spontaneously after surgical pericardiotomy, was reported in a 19-year-old patient who had a rejected liver transplantation, and had liver and kidney failure with pericardial tamponade. In this case, pneumopericardium was accompanied by pneumoperitoneum and subcutaneous emphysema; an extremely rare combination.
心包积气是指心包腔内积聚气体，与气胸和纵隔气肿相比，其发生率极低。临床表现多样，患者常无症状，轻症病例通常可自行缓解。然而，它可能导致心包填塞，这需要快速诊断和治疗，否则可能危及生命。传统的诊断方法是简单的立位胸部X线检查。通过该检查可发现典型表现，并可对纵隔气肿和心包积气进行鉴别诊断。超声心动图和胸部计算机断层扫描也可辅助诊断。迄今为止，文献中仅报道过1例心包切开术后发生心包积气的病例。在本病例报告中，一名19岁因肝移植排斥反应导致肝肾功能衰竭并伴有心包填塞的患者，术后发生了医源性心包积气，但该积气自行缓解。在该病例中，心包积气伴有气腹和皮下气肿，这是一种极为罕见的组合。
