A delayed case of tension pneumopericardium after total gastrectomy

A case of tension pneumopericardium that occurred after total gastrectomy in an 80 year old woman is presented. There have been some prior case reports of pneumopericardium that occurred during positive pressure ventilation; in this patient hypotension due to tension pneumopericardium occurred after extubation. Return of spontaneous ventilation with negative-pressure breathing may have induced air aspiration into the pericardial sac from the abdominal cavity.