Pneumomediastinum and pneumopericardium as rare complications after retroperitoneal transpsoas lateral lumbar interbody fusion surgery: A case report

A Very Rare Case of Isolated Spontaneous Pneumopericardium Secondary to COVID-19

Coronavirus disease 2019(COVID-19) is currently a pandemic. In addition to respiratory symptoms, involvement of other organs such as the pericardium is also seen. Pneumomediastinum in COVID-19 patients has rarely been reported. Isolated pneumopericardium without pneumomediastinum is even more uncommon. We described a case of COVID-19 in association with pneumopericardium. To the best of our knowledge, no case with isolated pneumopericardium has been reported thus far.

COVID-19 Associated Spontaneous Pneumothorax and Pneumopericardium: A Case Report

Novel coronavirus 2019 (COVID-19) has been one of the largest and most devastating global pandemics of our time. There have been several complications of this disease that have also proven to be debilitating and deadly. While primarily affecting the respiratory system, some cases presented with uncommon complications such as pneumopericardium and spontaneous pneumothorax. We present a case of an elderly female diagnosed with COVID-19 found to have both spontaneous pneumothorax and pneumopericardium. She had a complicated hospital course and ultimately succumbed to her illness. While the pathogenesis of these conditions is not yet fully understood, further studies are needed to help clinicians develop treatment and prevention strategies to improve patient outcomes.

Rare Complication of Pneumomediastinum and Pneumopericardium in a Patient with COVID-19 Pneumonia

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently discovered coronavirus which has caused a global outbreak of severe pneumonia with complications leading to hypoxic respiratory failure, acute respiratory distress syndrome (ARDS), cytokine storm, disseminated intravascular coagulation (DIC), and even gastrointestinal symptoms. While ground-glass opacity (GGO) is a typical radiographic finding associated most frequently with COVID-19 pneumonia, other less commonly noted atypical radiographic lung features include isolated lobar or segmental consolidation without GGO, discrete small nodules (centrilobular, “tree-in-bud”), lung cavitation, and smooth interlobular septal thickening with pleural effusion. Pneumomediastinum in COVID-19 patients has rarely been reported. A finding of pneumopericardium is unusual too. This report discusses the case of a young male with COVID-19 pneumonia who was found to have both these features on computed tomographic (CT) scans of his chest on presentation.

Lateral Lumbar Interbody Fusion: Review of Surgical Technique and Postoperative Multimodality Imaging Findings

The lateral lumbar interbody fusion (LLIF) approach is a minimally invasive surgery that can be used as an alternative to traditional lumbar interbody fusion techniques. LLIF accesses the intervertebral disk through the retroperitoneum and psoas muscle to avoid major vessels and visceral organs. The exposure of retroperitoneal structures during LLIF leads to unique complications compared with other surgical approaches. An understanding of the surgical technique and its associated potential complications is necessary for radiologists who interpret imaging before and after LLIF. Preoperative imaging must carefully assess the location of anatomic structures, including major retroperitoneal vasculature, lumbar nerve roots, lumbosacral plexus, and the genitofemoral nerve, relative to the psoas muscle. Multiple imaging modalities can be used in postoperative assessment including radiographs, CT, CT myelography, and MRI. Of these, CT is the preferred modality, because it can assess a range of complications relating to both the retroperitoneal exposure and the spinal instrumentation, as well as bone integrity and fusion status. This article describes surgical approaches for lumbar interbody fusion, comparing the approaches' indications, contraindications, advantages, and disadvantages; reviews the surgical technique of LLIF and relevant anatomic considerations; and illustrates for interpreting radiologists the normal postoperative findings and potential postsurgical complications of LLIF.