Spontaneous Pneumopericardium in an Otherwise Healthy Full‐term Newborn

Abstract

Neonatal pneumopericardium is usually a complication of mechanical ventilation in premature infants with respiratory distress syndrome. We report a full-term neonate who developed pneumopericardium after forceps delivery and mild asphyxia. The child was never ventilated and had no signs of parenchymal lung disease. The pneumopericardium resolved spontaneously. Although drainage of pneumopericardium is usually recommended, this may not always be necessary when there are no signs of cardiac tamponade.

Spontaneous Pneumopericardium in a Healthy Full-Term Neonate

“…In our patient, PPC was an incidental radiological finding. In some reports on pneumopericardium, inability to view the heart through echocardiographic windows was noted [4]. In the present case too echocardiography was not useful in evaluating the heart because of interfering air.…”

“…The increasing use of surfactant replacement therapy, antenatal steroids and gentler modes of ventilation have reduced the incidence of PPC. It can rarely occur spontaneously, as in present case [2][3][4]. In the review of literature, the authors came across very few cases in which PPC occurred and resolved spontaneously in a healthy term neonate.…”

“…Nitrogen and 100% oxygen has been successful in two cases which have been reported [3,4] and may be considered in stable term infants but not advisable in preterm neonates because of the risk of hyperoxia. It appears from the literature reviewed that the prognosis is much better in asymptomatic pneumopericardium which is not associated with other air leaks [8].…”

Preterm Neonate with Spontaneous Pneumopericardium without any Other Associated Air Leaks

“…Majority of late onset [3][4][5] (3 out of 4) required active intervention. All three cases [6][7][8] of early onset including the current one dose not required any active intervention.…”

“…There are a number of published cases of spontaneous isolated PPC in term neonates who had not received mechanical ventilation or active resuscitation at birth [6][7][8].…”