UNLABELLED A fatal complication of an incarcerated diaphragmatic hernia: pyo-pneumopericardium due to a gastro-pericardial fistula, case report and literature review INTRODUCTION The pyo-pneumopericardium is a very rare complication of an incarcerated diaphragmatic hernia. Usually, it depends on the existence of a gastropericardial fistula and, in most cases, it is a deadly complication. CA...

A 28-year-old Filipino male was admitted due to high-grade fevers and dyspnea on a background of chronic cough and weight loss. Due to clinical and echocardiographic signs of cardiac tamponade, emergency pericardiocentesis was performed on his first hospital day. Five days after, chest radiographs showed new pockets of radiolucency within the cardiac shadow, indicative of pneumopericardium. On ...

A20-year-old man without past medical history was admitted for diffuse left-sided and retrosternal chest pain after he was “told and forced to swallow crystal rocks.” He denied any prior symptomatology and denied cough. In the emergency department, he had a normal physical examination and laboratory studies. The ECG, however, showed diffuse ST-segment elevations (Figure 1). He was admitted to t...

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 sign...

While complete absence of the pericardium is a very rare abnormality, which is sometimes found during a post-mortem examination, we believe that partial deficiency resulting in a pleuropericardial communication is probably not quite as uncommon as the meagre literature on the subject would indicate. Powell in 1869 first recorded a case of partial deficiency of the pericardium. In 1925 Moore fou...

Mucor and Rhizopus cause life-threatening infections primarily involving the lungs and sinuses, which disseminate very rapidly by necrosis and infarction of the contiguous tissues. We present a case of a 64-year-old African American posttransplant patient who presented with a productive cough and weight loss. He had a past surgical history of renal transplant for renal cell carcinoma and was on...

A 71-year-old female with lung adenocarcinoma underwent surveillance PET/CT, which revealed new central necrotic cavitation of a preexisting left lower lobe mass, with communication between this air-filled cavity and the left mainstem bronchus, as well as pericardial effusion with large pneumopericardium, consistent with malignant bronchopericardial fistula (Fig. 1). Echocardiography and physic...

A 72-year-old man with a history of chemoradiation therapy for lung cancer and with known gastric ulcer was admitted due to chest pain. On day 6, a chest X-ray showed air around the heart (Picture 1) and computed tomography showed a fistula between the pericardium and the gastric ulcer (Picture 2). A diagnosis of cardiac tamponade caused by a pneumopericardium was made, and a drainage tube was ...