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Pneumopericardium in Infancy

JOHN W. LOFTIS, M.D.; ANTHONY F. SUSEN, M.D.; JOSEPH H. MARCY, M.D.; FRANK E. SHERMAN, M.D.
Am J Dis Child. 1962;103(1):61-65. doi:10.1001/archpedi.1962.02080020065010.
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Pneumopericardium is an unusual complication of mediastinal emphysema in infants. It is rarely recognized clinically, yet the symptoms and signs are characteristic, and the prompt relief of the gas tamponade by pericordotomy is lifesaving. Six infants with this condition have been observed in the past 2 years, and all were receiving positive pressure mechanical respiration. Two were recognized clinically, and prompt surgical measures were instituted with success.

It is the purpose of this paper to call attention to this condition, discuss the etiology, the signs and symptoms, surgical relief, and prevention.

Report of Cases  Case 1.—A white boy, 3½ months old was admitted because of progressive enlargement of the head, and studies revealed noncommunicating hydrocephalus. A ventriculoatrial operation was planned, and as the ankle phlebotomy was being performed prior to surgery, under endotracheal anesthesia, the heart sounds became progressively distant. The pulse was quenched, and cardiac arrest occurred. No

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