Open AccessAbdominal compartment syndrome by tension pneumoperitoneum secondary to barotrauma. Presentation case
Author(s) -
Esther García-Santos,
Alejandro Puerto-Puerto,
Susana Sánchez-García,
Francisco Javier Ruescas-García,
Ana Alberca-Páramo,
Jesús Martín-Fernández
Publication year - 2015
Publication title -
cirugía y cirujanos
Language(s) - English
Resource type - Journals
ISSN - 2444-0507
DOI - 10.1016/j.circen.2015.10.014
Subject(s) - pneumoperitoneum , medicine , abdominal compartment syndrome , perforation , respiratory distress , surgery , mechanical ventilation , decompression , mediastinum , anesthesia , abdomen , laparoscopy , materials science , punching , metallurgy
BackgroundPneumoperitoneum is defined as the existence of extraluminal air in the abdominal cavity. In 80–90% of cases is due to perforation of a hollow organ. However, in 10–15% of cases, it is nonsurgical pneumoperitoneum.ObjectiveThe case of a patient undergoing mechanical ventilation, developing abdominal compartment syndrome tension pneumoperitoneum is reported.Clinical caseFemale, 75 years old asking for advise due to flu of long term duration. Given her respiratory instability, admission to the Intensive Care Unit is decided. It is then intubated and mechanically ventilated. Chest X-ray revealed a large pneumoperitoneum but no pneumothorax neither mediastinum, and due to the suspicion of viscera perforation with clinical instability secondary to intra-abdominal hypertension box, emergency surgery was decided.ConclusionsWhen discarded medical history as a cause of pneumoperitoneum, it is considered that ventilation is the most common cause.Benign idiopathic or nonsurgical pneumoperitoneum, can be treated conservatively if the patient agrees. But if intraabdominal hypertension prevails, it can result in severe respiratory and haemodynamic deterioration, sometimes requiring abdominal decompression to immediately get lower abdominal pressure and thus improve haemodynamic function