title: Gastric rupture with tension pneumoperitoneum: a complication of difficult endotracheal intubation.
abstract: Gastric rupture is a rare complication of difficult airway management. In cases of vigorous mouth-to-mouth ventilation, bag-valve-mask ventilation, or esophageal intubation, gastric rupture and massive intraperitoneal free air may cause tension pneumoperitoneum. Hemodynamic instability necessitates immediate intervention, including needle decompression of the peritoneum followed by surgical exploration. We recently encountered two cases of gastric rupture with tension pneumoperitoneum that occurred after difficult endotracheal intubation. This report describes the presentation, treatment, and prevention of this entity.
authors.affiliation: Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Miller
authors.forename: K M
authors.initials: KM
authors.lastname: Itani
authors.forename: M D
authors.initials: MD
authors.lastname: Oza
authors.forename: M J
authors.initials: MJ
authors.lastname: Wall
mesh_terms: D000368:Aged; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000150:complications / Q000209:etiology*; D012422:Rupture, Spontaneous; D013272:Stomach Diseases / Q000150:complications / Q000209:etiology*