Penumopericardium and tension pneumopericardium after closed-chest injury.

Three recent cases of pneumopericardium after closed-chest injury are described. The mechanism of pericardial inflation suspected in each was pleuropericardial laceration in the presence of an intrathoracic air leak. Deflation of the pericardium was achieved by underwater seal drainage of the right pleural cavity in the first patient, during thoracotomy for repair of tracheobronchial rupture in the second, and by subxiphoid pericardiotomy in the last. Haemodynamic changes after escape of air from the periion pneumopericardium and air tamponade.