Pneumopericardium after abdominal surgery in the dog
Young bitch that underwent an elective ovariectomy a few days ago. Dorsoventral and lateral thoracic radiographs are taken at the postoperative check:
zoom_inEnlarge
Gas surrounds and outlines the heart, contained by the thin pericardial line. What best explains this finding after abdominal surgery?
chevron_right Show answer and explanation
A. Pneumomediastinum from endotracheal intubation
Pneumomediastinum outlines the great vessels, oesophagus and tracheal wall and may extend into the neck or retroperitoneum. It is not confined around the heart by the pericardial line.
B. Iatrogenic pneumothorax during anaesthesia
In pneumothorax the gas lies in the pleural space: it lifts the heart off the sternum and retracts the lobes from the wall, with no pericardial line containing it.
C. Pericarditis from gas-producing bacteria
It is exceptional and would come with a septic animal and abundant pericardial effusion. It is not the logical explanation after elective surgery.
D. Peritoneopericardial diaphragmatic hernia
Correct. Free abdominal gas persists for days after a laparotomy. If it appears inside the pericardium, there is a peritoneopericardial communication, almost always a congenital hernia; confirm it with ultrasound or CT (liver or gallbladder inside the pericardial sac).
lightbulb Key takeaway
Pneumopericardium is recognised because the gas surrounds the heart and is limited by the thin pericardial line, without outlining the great vessels. After abdominal surgery it indicates a communication with the peritoneum: look for a peritoneopericardial hernia.
Test yourself with 10 random questions
Diagnostic imaging · 200 questions, a different test every time
Related questions
Updated: November 1, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.