title: Tension pneumoperitoneum after blast injury: dramatic improvement in ventilatory and hemodynamic parameters after surgical decompression.
abstract: Tension pneumoperitoneum is a known although rare complication of barotrauma, which can accompany blast injury. We report two patients who suffered from severe pulmonary blast injury, accompanied by tension pneumoperitoneum, and who were severely hypoxemic, hypercarbic, and in shock. After surgical decompression of their pneumoperitoneum, respiratory and hemodynamic functions improved dramatically. Several mechanisms to explain this improvement are suggested. In such cases the release of the tension pneumoperitoneum is mandatory, and laparotomy with delayed closure can be contemplated.
authors.affiliation: Department of Anesthesia and Critical Care Medicine, Hadassah Medical Center and the Hebrew University of Jerusalem, Israel. galo@netvision.net.il
authors.forename: A
authors.initials: A
authors.lastname: Oppenheim
authors.forename: R
authors.initials: R
authors.lastname: Pizov
authors.forename: A
authors.initials: A
authors.lastname: Pikarsky
authors.forename: Y G
authors.initials: YG
authors.lastname: Weiss
authors.forename: G
authors.initials: G
authors.lastname: Zamir
authors.forename: C L
authors.initials: CL
authors.lastname: Sprung
authors.forename: A
authors.initials: A
authors.lastname: Rivkind
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000150:complications*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D018467:Positive-Pressure Respiration, Intrinsic; D013990:Tidal Volume