Successful management of pneumopericardium in an extremely low birth weight preterm using a 22-gauge intravenous catheter as a pericardial drain.

Pneumopericardium is relatively rare but potentially fatal in premature babies. When a massive pneumopericardium leads to cardiac tamponade, emergent pericardiocentesis is often required to save lives. In some cases, the placement of a pericardial drain for continuous drainage may be necessary. However, for very low birth weight or extremely low birth weight preterms, there is a lack of appropriately sized pericardial drain tubes, posing a clinical challenge. We report a case of a very low birth weight preterm baby, born at 1016 grams, who developed pneumopericardium. We successfully treated the pneumopericardium using a 22-gauge intravenous catheter.