Bubbles in Pericardial Fluid: Multimodality Imaging in Iatrogenic Hydropneumopericardium

The term hydropneumopericardium describes the simultaneous accumulation of fluid and gas in the pericardial sac. This condition is mostly caused by primary infiltrative lesions from the adjacent organs, pericardial infections, or trauma and is a very rare situation, usually with favorable outcomes. We describe a female patient with Lutembacher’s syndrome complicated by cardiac tamponade. After surgical treatment, she developed iatrogenic hydropneumopericardium, which was treated conservatively. Iatrogenic hydropneumopericardium can be managed conservatively with supportive measures, and most of these cases resolve spontaneously if they are not large and destabilizing.