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Eur J Cardiothorac Surg 2003;23:131-133
© 2003 Elsevier Science NL

Case report

Pneumopericardium due to intrapericardial perforation of a gastric ulcer

^a Department of Thoracic and Hyperbaric Surgery, University Medical School of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria
^b Division of Pneumology, Enzenbach, Austria

Received 3 July 2002; received in revised form 10 September 2002; accepted 1 October 2002.

* Corresponding author. Tel.: +43-316/385-2803; fax: +43-326/385-4679
e-mail: sabine.gabor{at}kfunigraz.ac.at

A 88-year-old male patient presented with fever, singultus and retrosternal pain. After 8 days of antibiotic therapy not resulting in clinical improvement, he suddenly developed a pneumopericardium. Contrast swallow and endoscopy showed intrapericardial perforation of a benign gastric ulcer. Excision of the ulcer and suturing of both the stomach and the diaphragm as well as lavage of the pericardium were done over a left thoracotomy. The patient recovered uneventfully.

Key Words: Pneumopericardium • Stomach • Ulcer • Perforation • Diaphragm