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Serial chest films are needed after a diagnosis of pneumopericardium because of risk of cardiac herniation
Authors:Kamiyoshihara Mitsuhiro  Nagashima Toshiteru  Baba Shinji  Shimizu Kimihiro  Takeyoshi Isumi
Affiliation:a Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
b Department of Emergency and Critical Care Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
c Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
Abstract:A 76-year-old man was transferred to our institution with blunt chest trauma after falling off a roof. Chest computed tomography (CT) revealed left pneumothorax and pneumopericardium but no displacement of the heart into the hemithorax. These findings suggested traumatic pericardial rupture without cardiac herniation. After chest drainage, a follow-up CT scan demonstrated no pericardial or pleural air. At thoracotomy, we observed that the pericardium was torn and that the heart was exposed. The tear was repaired with direct sutures. This case report highlights the importance of reviewing the initial CT scan.
Keywords:32
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