Pneumopericardium after pericardiocentesis for malignant pericardial effusion

Q: What does this research mean for the field?

Computed tomography can resolve misleading chest radiographic findings to confirm pneumopericardium and verify correct intrapericardial catheter placement following pericardiocentesis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Machiko Miyoshi; Kanae Hasegawa; Kentaro Ishida; Hiroshi Tada

doi:10.1093/ehjcr/ytag713

September 21, 2026European Heart Journal - Case ReportsOpen Access

Pneumopericardium after pericardiocentesis for malignant pericardial effusion

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Key result

CT clarifies drainage catheter position and confirms pneumopericardium after pericardiocentesis when radiography is misleading.

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Why the study?

Pneumopericardium after pericardiocentesis is a rare but recognized complication that can be challenging to diagnose accurately.

Key Points

To describe the diagnostic utility of computed tomography in distinguishing true catheter position and detecting pneumopericardium after pericardiocentesis.
Evaluated a clinical case of suspected catheter misplacement following pericardiocentesis for malignant pericardial effusion.
Compared initial diagnostic chest radiography against subsequent thoracic computed tomography imaging.
Chest radiography displayed ambiguous findings suggesting inadvertent intracardiac placement of the drainage catheter.
Computed tomography demonstrated that the catheter resided entirely within the intrapericardial space and definitively identified post-procedure pneumopericardium.

Structured PICO

P

Population

n=1, 49-year-old woman with recurrent malignant pericardial effusion from metastatic renal cell carcinoma presenting with progressive dyspnoea.

I

Intervention

Subxiphoid pericardiocentesis with echocardiographic and fluoroscopic guidance, followed by computed tomography for catheter visualization and continuous suction (started at 12 cmH2O, reduced to 10 cmH2O) for complication management.

Computed tomography is a valuable tool to accurately assess drainage catheter position and confirm pneumopericardium when standard chest radiography and echocardiography are obscured or misleading.

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Implication

CT may clarify misleading radiography after pericardiocentesis; case reports leave open standardized diagnostic protocols.

Abstract

Pneumopericardium after pericardiocentesis is a rare but recognized complication. In this case, computed tomography clarified the true intrapericardial position of the drainage catheter and confirmed the diagnosis when chest radiography created the misleading impression of an intracardiac catheter.

Discussion

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Cite This Study

Miyoshi et al. (2026) studied this question. Computed tomography clarified the true intrapericardial position of a drainage catheter and confirmed pneumopericardium after pericardiocentesis when chest radiography was misleading.

synapsesocial.com/papers/6ad1157100741cc3fba7d3dc https://doi.org/10.1093/ehjcr/ytag713

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Pneumopericardium after pericardiocentesis for malignant pericardial effusion

Figures

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Pneumopericardium after pericardiocentesis for malignant pericardial effusion

Figures

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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