A 6-month-old girl presented with respiratory failure due to respiratory infection requiring intubation. Her pre-intubation chest x-ray is shown in Figure, A. Thirty minutes subsequently, the patient developed an acute syndrome characterized by difficulty to ventilate, hypotension, and bradycardia. A repeat chest x-ray revealed pneumopericardium without associated pneumothorax (Fig, B). Emergent pericardiocentesis and placement of a pericardial drain resulted in immediate return of normal sinus rhythm, and improvement in blood pressure and oxygenation. A repeat chest x-ray demonstrated resolution of the pneumopericardium (Fig, C). Bronchoscopy was performed during the hospital course with no evidence of tracheobronchial injury and the pericardial drain was removed.
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Published online: December 04, 2009
Accepted: October 5, 2009
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.