The spontaneous pneumopyopericardium simultaneously masquerading as acute myocardial infarction and surgical abdomen: a case report.

Pneumopyopericardium is a rare disease, presenting clinically as a spectrum of acute myocardial infarction or severe surgical abdomen, which includes various symptoms and changes in cardiac enzymes and electrocardiogram. Here, we report a case of pneumopyopericardium in a 61-year-old male farmer in China. An early diagnosis of pneumopyopericardium was difficult due to his acute myocardial infarction– and severe surgical abdomen–like symptoms and signs. The electrocardiogram, esophagogram, and chest computed tomographic scan commonly revealed pericardial fluid and air and excluded a gastrointestinal perforation in late stage of severe inflammation. Despite therapy with antibiotics and pericardial open surgical drainage, his severe inflammation was not well controlled, partly due to the pericardial cavity drainage obstruction induced by pericardial adhesion. The present case indicated the importance of early diagnosis and treatment of pneumopyopericardium.