Pneumopericardium in blunt chest trauma after high-speed motor vehicle accidents

Ladurner, Roland; Qvick, Lars M.; Hohenbleicher, Felix; Hallfeldt, Klaus; Mutschler, Wolf; Mussack, Thomas

doi:10.1016/j.ajem.2004.01.003

Cited by 36 publications

(38 citation statements)

References 13 publications

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“…The CT scan confirms the diagnosis, and it should include abdomen and thorax for detection of possible accompanying injuries. Echocardiography is not used for routine diagnosis of pneumopericardium, because the passage of the ultrasound waves throughout the air is weak [1]. In our case, at CXR, an air image was found around the cardiac silhouette.…”

Section: Discussionmentioning

confidence: 88%

“…Usually self-limiting pneumopericardium may alternate to tension pneumopericardium which would require pericardial drainage through the opening of an emergent pericardial window or pericardial suctioning. For this reason, patient should be followed in ICU with cardiac and blood pressure monitoring [1]. Acute hemodynamic deterioration in a patient with pneumopericardium should prompt further investigation, and cardiac tamponade should be actively ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Pneumopericardium is usually a self-limited condition with no specific therapy, but may progress to tension pneumopericardium. Tension pneumopericardium is a life-threatening cardiac tamponade which requires an immediate pericardial aspiration and subsequent pericardial drainage via a pericardial window or emergent open subxyphoid approach to the pericardium [1]. The deep sulcus sign is the lucency of the costophrenic angle extending toward the hypochondrium.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pneumopericardium and Deep Sulcus Sign After Blunt Chest Trauma

Beton¹,

Kaplanoğlu²,

Bulut³

et al. 2016

Ann Clin Anal Med

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ÖzetPnömoperikardiyum, perikard yaprakları arasında hava bulunması olarak tanımla-nır. Genellikle kendini sınırlar, tansiyon pnömoperikardiyum oluşturduğu durumda ise hızlı sıvı resüsitasyonu ve hemodinamik kontolü takiben, perikardiyal pencere açılması veya drenaj gerektirir. Yüksekten düşme sonrası acil serviste değerlendi-rilen 49 yaşındaki erkek hastada, supin pozisyonda çekilen akciğer grafisinde; derin sulkus bulgusu, ciltaltı amfizemi, çoklu kot fraktürü, bilgisayarlı tomografide; perikardial serbest hava, sağ pnömotoraks ve ciltaltı amfizemi tespit edildi. Hasta sağ tüp torakostomi uygulanarak yoğun bakım takibine alındı. Kardiyak enzim takipleri yapıldı. Takiplerinde tansiyon pnömoperikardiyum gelişmedi. Cilt altı amfizemi geriledi. Travma sonrası onuncu gün çekilen tomografisinde pnömoperikar-diyum alanının tamamen gerilediği görüldü. Anahtar KelimelerPnömoperikardiyum; Pnömotoraks; Akciğer Grafisi Abstract Pneumopericardium is defined as air between the leaves of the pericardium, which is usually self-limited. In tension pneumopericardium, however, rapid fluid resuscitation and haemodynamic monitoring followed by pericardial fenestration and drainage should be performed. A 49-year-old male falling from height was brought to the emergency room. On chest X-ray in supine position, a deep sulcus sign and subcutaneous emphysema with multiple rib fractures were detected. At computerized tomography, pericardial free air, right pneumothorax and subcutaneous emphysema were detected. A tube thoracostomy was applied to the patient. During follow-up with cardiac enzymes in the intensive care unit, no tension pneumopericardium developed, and subcutaneous emphysema regressed. A control computerized tomography scan showed a complete regression in the pneumopericardium on the tenth day.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pneumopericardium and Deep Sulcus Sign After Blunt Chest Trauma

Beton¹,

Kaplanoğlu²,

Bulut³

et al. 2016

Ann Clin Anal Med

View full text Add to dashboard Cite

show abstract

“…(3,4) Intubation with positive pressure ventilation supports the re-entering of the air into the pericardial space particularly in presence of pneumothorax and disables its output from pericardial sack. Capizzi PJ analysed 32 patients with pneumopericardium after blunt chest trauma.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic pneumopericardium after blunt chest trauma

2015

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A 49-year-old man was admitted to the emergency room after a fall from a height of 4 m. He was conscious with intact neurological status and stabile vital function. Blunt chest trauma was presented with left side rib fractures (3-6), ipsilateral lung base contusion, pneumo-liqidothorax, pneumomediastinum and subcutaneus emphysema. A computed tomographic scan also confirmed pneumopericardium. Negative Hamman's sign were presented. Although the patient had no symptoms, the presence of pneumopericardium might be a sign of severe injury and indicates the potential risk of cardiac tamponade and a lifethreatening condition. In the presence of pneumopericardium, cardiac tamponade could be triggered secondary by mechanical ventilation support. In our case report, we would like to stress the importance of early diagnostic of asympthomatic pneumopericardium after blunt chest trauma, which may be decisive in choosing the optimal therapeutic procedure.

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“…In some cases tension pneumopericardium compressing the heart has been reported, usually after the initiation of mechanical ventilation [1][2][3]. We report a case of near-tension pneumopericardium after blunt trauma in a polytrauma patient, which was treated conservatively, avoiding the use of positivepressure ventilation.…”

mentioning

confidence: 94%