Tension Pneumopericardium Causing Cardiogenic Shock due to Blunt Injury to the Chest

Abstract

Pneumopericardium is an exceptionally uncommon phenomenon in the setting of blunt polytrauma. It is imperative for trauma providers to identify tension pneumopericardium despite its rarity. A 22-year-old male motorcyclist presented to the hospital after colliding with a car going approximately 50 mph. The patient was hemodynamically unstable and had diminished breath sounds bilaterally. Bilateral chest tubes were placed, yielding little improvement in condition. While obtaining CT imaging, pneumopericardium was promptly identified. Pulses were lost immediately before pericardiocentesis, and resuscitative thoracotomy was performed. The pericardial sac was tense and an immediate gush of air released upon incising the sac. The patient was taken immediately to the Operating Room for further exploration and repair.