Abstract
Pneumopericardium is a rare clinical finding with various etiologies. Pneumopericardium ranges from an asymptomatic to life-threatening condition, e.g., in cases of cardiac tamponade. The underlying etiology should be sought so that treatment can be expedited. Pneumopericardium may result from traumatic and nontraumatic etiologies. Although the mortality associated with pneumopericardium is high, its rarity precludes determination of its true incidence. We present an unusual case of pneumopericardium due to gastropericardial fistula which developed as a delayed complication of a Roux-en-Y gastric bypass performed 11 years prior.
Similar content being viewed by others
References
Killeen K, Poletti PA, Shanmuganathan K, Mirvis SE (1999) CT diagnosis of cardiac and pericardial injuries. Emerg Radiol 6:339–344
Ghanem N, Altehoefer C, Springer O et al (2003) Radiological findings in Boerhaave’s syndrome. Emerg Radiol 10:8–13. doi:10.1007/s10140-002-0264-1
Grandhi TM, Rawlings D, Morran CG (2004) Gastropericardial fistula: a case report and review of literature. Emerg Med J: EMJ 21:644–645. doi:10.1136/emj.2003.007765
Servais EL, Stiles BM, Spector JA, Altorki NK, Port JL (2012) Gastropericardial fistula: a late complication of esophageal reconstruction. Ann Thorac Surg 93:1729–1731. doi:10.1016/j.athoracsur.2011.09.075
Chapman PR, Boals JR (1998) Pneumopericardium caused by giant gastric ulcer. AJR Am J Roentgenol 171:1669–1670
Salling N, Falensteen AM, Larsen LG (1983) Non-traumatic perforation of gastric ulcer in a hiatal hernia to the pericardium. Acta medica Scandinavica 213:225–226
Murthy S, Looney J, Jaklitsch MT (2002) Gastropericardial fistula after laparoscopic surgery for reflux disease. N Engl J Med 346:328–332. doi:10.1056/NEJMoa010259
Kim WJ, Choi EJ, Oh YW, Kim KT, Kim CW (2011) Gastropericardial fistula-induced pyopneumopericardium after esophagectomy with esophagogastrectomy. Ann Thorac Surg 91:e10–e11. doi:10.1016/j.athoracsur.2010.09.082
West AB, Nolan N, O’Briain DS (1988) Benign peptic ulcers penetrating pericardium and heart: clinicopathological features and factors favoring survival. Gastroenterology 94:1478–1487
Miller J, Festa S, Karimi S, Maldjian P, Baker SR (1998) Common anatomic variants simulating mediastinal pathology on chest radiographs: confirmation with alternate imaging modalities. Emerg Radiol 5:219–230
Simice P, Zwirewich CV (2000) Gastropericardial fistula complicating benign gastric ulcer: case report. Can Assoc Radiol J = J l’Assoc Can Radiol 51:244–247
Hall MN, Little JM Jr (1990) Penetration of the pericardium by a gastric ulcer—survival after pericardiocentesis. J Am Board Fam Pract / Am Board Fam Pract 3:289–291
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rodriguez, D., Heller, M.T. Pneumopericardium due to gastropericardial fistula: a delayed, rare complication of gastric bypass surgery. Emerg Radiol 20, 333–335 (2013). https://doi.org/10.1007/s10140-013-1109-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-013-1109-9