Pneumopericardium: A Rare Complication of Antireflux Surgery

Pneumopericardium is a rare clinical entity, occurring in the setting of thoracic trauma, malignancies, or mechanical ventilation. Very few cases report pneumopericardium as complication gastrointestinal tract surgery. Signs and symptoms may be frustrating, ranging from asymptomatic to chest pain, sepsis, hemodynamic instability, pericarditis, even cardiac tamponade. Clinical pathognomonic signs include pericardial metallic tinkling friction rub mill wheel murmur. Diagnostic work-up includes electrocardiogram, radiography, and, computed tomography imaging. A gastro fistula should considered differential diagnosis for acute pain patients with history gastroesophageal Rapid recognition treatment avoid life-threatening complications. The successful outcome depends on both emergency definitive surgical management. survival rate conservative management poor. We present case 78-year-old patient suffering infusion, due fibrotic between Nissen’s valve, 10 years after redo antireflux Treatment included broad-spectrum antibiotics, surgery drainage, biopsy valve’s defect, suture, omentoplasty.