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T. G. Buchman, B. L. Hall, W. M. Bowling, G. D. Kelen, et al., Eds., “Thoracic Trauma,” In: Judith Tintinalli’s Emergency Medicine—A Comprehensive Study Guide, 6th Edition, McGraw-Hill, New York, 2004, p. 1595

has been cited by the following article:

• TITLE: Pitfalls in Diagnosing a Tension Pneumopericardium—A Case Report

  AUTHORS: Shankar Hanamantrao Hippargi, Vinayak Tonne

  KEYWORDS: Tension Pneumopericardium; Cardiac Tamponade; Traumatic Pneumopericardium; Pneumo-Tamponade; Small Heart Sign

  JOURNAL NAME: International Journal of Clinical Medicine, Vol.4 No.4, April 30, 2013

  ABSTRACT: A 65-year-old female patient was brought to our emergency department (ED) with alleged history of road traffic collision (RTC). The patient had respiratory distress on arrival and hence she was immediately intubated and ventilated. Blood pressure and peripheral pulses were not measurable; however the central pulses were present. Aggressive fluid resuscitation was started. Primary assessment revealed distended neck veins, bony crepitus over right chest. Bedside plain chest radiograph and focused assessment with sonograph in trauma (FAST) were done which did not establish an immediate diagnosis. Computed tomography (CT) of the thorax revealed a tension pneumopericardium and moderate right hemopneumothorax, with multiple ribs fracture. An intercostal drainage tube (ICD) was inserted on right chest. The patient suffered a cardiac arrest and resuscitation measures were unsuccessful. The diagnostic pitfalls, the CT findings, possible clues to the diagnosis and the discussion of this rare case are presented in this case report.