Tension pneumoperitoneum: Case report of a rare form of acute abdominal compartment syndrome.
Int J Surg Case Rep 2019;
55:112-116. [PMID:
30716704 PMCID:
PMC6360270 DOI:
10.1016/j.ijscr.2019.01.014]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/04/2019] [Accepted: 01/19/2019] [Indexed: 12/12/2022] Open
Abstract
Pneumoperitoneum is a rare cause of ACS.
A defined approach has not been established.
Whenever possible a minimally invasive approach should be attempted.
Avoiding laparotomy may benefit certain patients.
Reports are important in order to establish a treatment protocol.
Introduction: Tension pneumoperitoneum is a severe and rare form of pneumoperitoneum with concomitant hemodynamic instability and respiratory failure. It is a variant of abdominal compartment syndrome (ACS) causing an abrupt increase in intra-abdominal pressure.
Presentation of case: We present a case of pneumoperitoneum, after an endoscopic mucosal resection with the development of ACS. The patient was successfully treated with percutaneous decompression.
Discussion: Decompressive laparotomy is the first treatment option for both most forms of pneumoperitoneum and ACS; nevertheless, this issue is controversial. Recent reports have shown that some patients may be candidates for a minimally invasive catheter decompression avoiding major decompressive surgery. Identifying these patients is vital to avoiding unnecessary surgeries.
Conclusions: Tension pneumoperitoneum is a life-threatening event, early detection and intervention is critical in order to provide prompt and optimal treatment approaches.
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