Pneumopericardium

Case contributed by Muhammad Asadullah Munir
Diagnosis almost certain

Presentation

Preterm baby on positive pressure ventilation.

Patient Data

Age: 3 days
Gender: Female

Chest (AP view - portable)

x-ray

ETT and NG tube are malposition. Their urgent repositioning is recommended. Umbilical vein catheter is seen in situ. There is moderate pneumopericardium. Ill-defined air space opacification is noted in both lungs with predominant involvement of left upper zone and in right perihilar region. These findings are suggestive of pulmonary infection. Differential may include hyaline membrane disease. Slightly increased lucency of left costophrenic angle is noted, suspicious for minimal pneumothorax. Transverse cardiac diameter cannot be commented due to AP projection. No pleural effusion is present. No significant bony pathology is evident.

Case Discussion

Lucent area is seen circumferentially surrounding and outlining the entire heart suggestive of pneumopericardium.

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