Non-Surgical Pneumoperitoneum Complicating Mechanical Ventilation

Youssef Motiaa*, wafae El Otmani, Nadia Boutayeb, Brahim Elahmadi, Abdelilah Ghannam and Zakaria Houssein Belkhadir

Received: April 19, 2018;   Published: April 30, 2018

DOI: 10.32474/CTGH.2018.01.000103

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Abstract

The occurrence of a pneumoperitoneum is usually linked to intra-abdominal hollow-organ perforation and generally requires emergency abdominal surgery. In 5 to 15% of cases, the pneumoperitoneum is not related to organ perforation and could be caused by various aetiologies. Barotrauma secondary to either invasive or non invasive mechanical ventilation can cause a pneumomediastinum with air diffusion to retroperitoneum and peritoneal cavity with extensive subcutaneous emphysema. We present a case of a fifty-six-year-old patient with a permanent tracheostomy for oropharyngeal neoplasm, admitted to Intensive Care Unit (ICU) for severe pneumonia requiring mechanical ventilation leading to pneumoperitoneum and retropneumoperitoneum with extensive subcutaneous emphysema. We also discuss Investigations and management challenges for this patient.

Keywords: Mechanicalventilation; Barotraumas; Pneumoperitoneum; Retropneumo-peritoneum; Conservative Management

Abbrevations: ICU: Intensive Care Unit; CT: Commuted Tomography

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