Pneumopyopericardium Secondary to Perforation of Benign Gastric Ulcer

PNEUMOPYOPERICARDIUM is itself exceedingly uncommon and occurs even more rarely as a complication of benign gastric ulceration. We have found only ten case reports in the literature. The first of these was described by Hallin¹in 1863, and the last by Frey²in 1961. Pick³reviewed six of the cases reported prior to 1894 in his monograph on perforations through the diaphragm from gastric ulcers, and the remaining three were reported by Parisot⁴(1885), Mathieu and Alivistros⁵(1918), and Dassel and Kirsh⁶(1954). Perforation of a gastric ulcer with the formation of a subphrenic abscess and subsequent dissection through the diaphragm into the pericardium was the usual course of events, with the exception of Frey's case where there was direct extension from an ulcer in a hiatus hernia. The general subject of pneumopyopericardium has been reviewed by Meyer.⁷The etiology of this condition includes