Pneumopericardium after pericardiocentesis

Pericardial effusion is a common clinical finding that can arise from a wide range of etiologies, including infections, malignancies, autoimmune disorders, and iatrogenic causes. Management often requires pericardiocentesis, particularly when large effusions cause hemodynamic compromise or diagnostic clarification is necessary. While pericardiocentesis is generally a safe procedure when performed under imaging guidance, complications can still occur, particularly in elderly patients or those receiving anticoagulation therapy. One rare but important complication is pneumopericardium—the presence of air within the pericardial space—which may result in serious consequences such as cardiac tamponade or pericardial irritation if not promptly recognized and managed.