Abstract
The conditions of pneumo-hydro-pericardium and pneumo-pyo-pericardium are rarely diagnosed. They may exist, yet their presence may be unsuspected owing to their insidious development during the progress of a grave lesion or owing to the physical signs and symptoms of the primary lesion masking those of these conditions. Pneumo-pyo-pericardium may arise from any lesion which leads to perforation of the pericardium from within or without—thus it may be associated with: (1) Rupture of the pericardium by a foreign body in the oesophagus or stomach or by a puncture wound. (2) Paracentesis. (3) Direct violence—with or without a definite fracture of a rib or the sternum. (4) Artificial pneumothorax. (5) The breaking down of a tuberculous lesion which is in close proximity to the pericardium. (6) The rupture of inflammatory lesions near the pericardium—abscess (lung, liver, subdiaphragmatic), empyema, etc. (7) Carcinomatous ulceration of oesophagus, bronchi or stomach.
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