Pneumopericardium

  • Etiology: barotrauma
  • Imaging: air in pericardial space which does not rise above great vessels, continuous diaphragm sign, subset of pneumomediastinum
  • Clinical: can cause compromise of venous return -> cardiac tamponade -> death

Cases of Pneumopericardium

CXR of esophageal perforation from nasogastric tube placement
CXR AP shows air outlining the heart in the pericardial space, air outlining the thymus in the mediastinum, and air in the bilateral pleural spaces.
CXR of pneumopericardium
CXR AP (above) shows a large amount of air around the heart. CXR AP obtained after pericardiocentesis (below) shows a decreased amount of air around the heart and the diaphragm can be continuously traced across the image.