Chest drain associated neonatal pneumopericardium

Abdul Qader Tahir Ismail 1 , Eshan Senanayake 2 , Kalyana Kumar Gurusamy 3 , Natasha Khan 2 , and Babu Kumararatne 3
  • 1 Neonatal unit, New Cross Hospital, Wednesfield Road, Wolverhampton, WV10 0QP, United Kingdom of Great Britain and Northern Ireland, Phone: +44 1902 307999
  • 2 Cardiothoracic surgery, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham, B4 6NH, United Kingdom of Great Britain and Northern Ireland
  • 3 Neonatal unit, New Cross Hospital, Wednesfield Road, Wolverhampton, WV10 0QP, United Kingdom of Great Britain and Northern Ireland
Abdul Qader Tahir Ismail, Eshan Senanayake, Kalyana Kumar Gurusamy, Natasha Khan and Babu Kumararatne

Abstract

Incidence of pneumopericardia in neonates has reduced significantly since the routine administration of surfactant and synchronised modes of ventilation. The majority now occur secondary to the more common air leaks, e.g. pneumothorax, pneumomediastinum, pulmonary interstitial emphysema (PIE); although there are case reports of spontaneous pneumopericardia in the absence of known risk factors. In most cases the air will resorb without active management but if a tension pneumopericardium develops urgent drainage is required to prevent cardiovascular compromise and death. We present a rare case of iatrogenic tension pneumopericardium in a preterm baby secondary to chest drain insertion for a pneumothorax. The resulting air leak was sufficient to require surgical repair via a median sternotomy. This is a previously unreported complication of chest drain insertion in a neonate, and highlights the importance of careful drain placement.

  • [1]

    Itani MH, Mikati MA. Early onset neonatal spontaneous pneumopericardium. J Med Liban. 1998;46:165–7.

    • PubMed
    • Export Citation
  • [2]

    Hook B, Hack M, Morrison S, Borawski-Clark E, Newman NS, Fanaroff A. Pneumopericardium in very low birth weight infants. J Perinatol. 1995;15:27–31.

    • PubMed
    • Export Citation
  • [3]

    Hummler HD, Bandstra ES, Abdenour GE. Neonatal fellowship. Neonatal pneumopericardium: successful treatment with nitrogen washout technique. J Perinatol. 1996;16:490–3.

    • PubMed
    • Export Citation
  • [4]

    Mansfield PB, Graham CB, Beckwith JB, Hall DG, Sauvage LR. Pneumopericardium and pneumomediastinum in infants and children. J Pediatr Surg. 1973;8:691–9.

    • Crossref
    • PubMed
    • Export Citation
  • [5]

    Burt TB, Lester PD. Neonatal pneumopericardium. Radiology. 1982;142:81–4.

    • PubMed
    • Export Citation
  • [6]

    Lawson EE, Gould JB, Taeusch HW, Jr. Neonatal pneumopericardium: current management. J Pediatr Surg. 1980;15:181–5.

    • PubMed
    • Export Citation
  • [7]

    Dougeni ED, Delis HB, Karatza AA, Kalogeropoulou CP, Skiadopoulos SG, Mantagos SP, et al. Dose and image quality optimization in neonatal radiography. Br J Radiol. 2007; 80:807–15.

    • Crossref
    • PubMed
    • Export Citation
  • [8]

    Lobo L. The neonatal chest. Eur J Radiol. 2006;60:152–8.

Purchase article
Get instant unlimited access to the article.
$42.00
Log in
Already have access? Please log in.


or
Log in with your institution

Journal + Issues

Search