Pneumopericardium

Case contributed by Henry Knipe
Diagnosis certain

Presentation

ICU. Intubated. Routine x-ray.

Patient Data

Age: 50 years
Gender: Male
x-ray
Download
Info

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

Eight hours later

ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial lung
window
Download
Info

Extensive pneumomediastinum (including small volume pneumopericardium) and subcutaneous emphysema. No pneumothorax. Left psoas hematoma 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. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.