Pneumopericardium

Case contributed by Dr Henry Knipe

Presentation

ICU. Intubated. Routine x-ray.

Patient Data

Age: 50 years
Gender: Male
Modality: X-ray

Patient is intubated with a left central venous catheter. NGT with tip in the mid-oesophagus. Bibasal opacities. Lucency outlines the heart with a small volume of subcutaneous emphysema in the root of the neck. 

Eight hours later

Modality: CT

Extensive pneumomediastinum (including small volume pneumopericardium) and subcutaneous emphysema. No pneumothorax. Left psoas haematoma is partially imaged. 

Case Discussion

The most likely cause is barotrauma from positive pressure ventilation. Marked worsening in the 8 hours between studies is also seen. 

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Case Information

rID: 44191
Case created: 11th Apr 2016
Last edited: 27th Jun 2016
Systems: Chest, Cardiac
Inclusion in quiz mode: Excluded

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