Eur J Cardiothorac Surg 1999;15:224
© 1999 Elsevier Science NL
Images in cardio-thoracic surgery |
Pneumopericardium after thoracic stab wound
Miralem Pasica,
Roland Hetzer1
1 Deutsches Herzzentrum Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
Received 26 October 1998;
accepted 27 October 1998.
a Corresponding author. Tel.: +49-30-4593-2018; fax: +49-30-4593-2018; e-mail: pasic@dhzb.de
A 26-year-old man with a right-sided thoracic knife stab wound
was referred to our institution because of suspected concomitant heart
injury. The right-sided partial pneumothorax with very small
haematothorax had been treated at the primary hospital by a chest tube
insertion. The small (6–7 mm) skin wound was located in the
right medioclavicular line in the third intercostal space. Standard
anteroposterior chest X-ray performed in the standing position
(Fig. 1A) revealed no
pneumothorax but pneumopericardium (arrowheads) in the upper parts of
the pericardial sac. Computed tomography performed in the supine
position (Fig. 1B)
demonstrated air in the pericardium (arrowheads) behind the sternum
without pericardial effusion. The patient was kept under observation
but no surgery was performed. Several repeated echocardiographic
examinations showed no pericardial effusion. The clinical status of
the patient was completely stable and the hospital stay was
uneventful. The pneumopericardium resorbed spontaneously without any
sequelae.
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Fig. 1A. (A) Standard anteroposterior chest X-ray performed in the standing
position revealing pneumopericardium (arrowheads) in the upper parts
of the pericardial sac but no pneumothorax. (B) Computed tomography
performed in the supine position demonstrating air in the pericardium
(arrowheads) behind the sternum with no pericardial
effusion.
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