Abstract
A pneumopericardium is a very rare condition and is the least common form of air leak in neonates. A tension pneumopericardium is associated with very high mortality. Neonatal pneumopericardium is usually a complication of mechanical ventilation in premature infants with respiratory distress syndrome. The mechanism of this rare condition and the perforation site of the pericardium have largely been speculative. This case report documents an extremely low birth weight infant who developed fatal tension pneumopericardium, and the autopsy revealed airflow into the pericardial sac through a perforation site of the pericardium near the ostia of the right pulmonary vein. This is a valuable case in which the perforation site of the pericardium was confirmed.
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