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Postoperative hydropneumopericardium
  1. E Aidala,
  2. A Valori,
  3. P A Abbruzzese
  1. enri.ematiscalinet.it

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A 20 year old man with a sinus venosus atrial septal defect underwent surgical correction with a pericardial baffle; the superior vena cava was not patched. Seven days postoperatively he developed pericardial effusion, which was initially treated with non-steroidal anti-inflammatory drugs. The pericardium was subsequently drained surgically, through a subxyphoid approach, after an unsuccessful percutaneous attempt. A pericardial drain was inserted the day after the procedure because of a hydropneumopericardium, revealed by standard chest x ray (left). We hypothesise that air trapping in the pericardium occurred because of a valve mechanism caused by the anti-Trendelenburg position.


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Chest x ray of the pericardium showing trapped air (arrows) and effusion level (arrowheads).

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