Tension pneumoperitoneum: Case report of a rare form of acute abdominal compartment syndrome. (2019)

• Record Type: Journal Article
• Authors: Cadena, Manuel; Solano, Jaime; Caycedo, Nicolas; Gomez, Daniel; Vinck, Eric E.; Quiroga, Pedro; Gaete, Paula
• Is Part Of: International journal of surgery case reports. Volume 55(2019)
• Page Start: 112
• Page End: 116
• Publication Date: 2019
• Subjects: Abdominal compartment syndrome -- Pneumoperitoneum -- Tension pneumoperitoneum -- Surgical decompression -- Laparotomy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2019.01.014
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: 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. Abstract: 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.