Pneumopericardium due to gastropericardial fistula: A delayed, rare complication of gastric bypass surgery

Pneumopericardium is a rare clinical finding with various etiologies. Pneumopericardium ranges from an asymptomatic to life-threatening condition, e.g., in cases of cardiac tamponade. The underlying etiology should be sought so that treatment can be expedited. Pneumopericardium may result from traumatic and nontraumatic etiologies. Although the mortality associated with pneumopericardium is high, its rarity precludes determination of its true incidence. We present an unusual case of pneumopericardium due to gastropericardial fistula which developed as a delayed complication of a Roux-en-Y gastric bypass performed 11 years prior. © 2013 Am Soc Emergency Radiol.