Serial chest films are needed after a diagnosis of pneumopericardium because of risk of cardiac herniation.
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.
Kamiyoshihara
Mitsuhiro
M
Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Japan. micha2005jp@yahoo.co.jp
Nagashima
Toshiteru
T
Baba
Shinji
S
Shimizu
Kimihiro
K
Takeyoshi
Isumi
I
D000368:Aged; D006331:Heart Diseases / Q000517:prevention & control*; D006335:Heart Injuries / Q000150:complications; D006547:Hernia / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010496:Pericardium / Q000293:injuries; D011026:Pneumopericardium / Q000150:complications / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed