Postoperative tension pneumoperitoneum in an infant.
A 9-week-old boy developed massive postoperative abdominal distension following a Fredet-Ramstedt pyloromyotomy for hypertrophic pyloric stenosis. A plain abdominal X-ray film was suggestive of a tension pneumoperitoneum. Passage of a cannula into the peritoneal space resulted in forceful expulsion of air, resulting in relief of the distension, which recurred after a few hours. At laparotomy, the tension pneumoperitoneum was due to a pyloric fistula at the proximal end of the pyloromyotomy, although a mucosal breach at the first operation had been at the distal end. Closure of the fistula resulted in complete resolution. A limited review of the literature is undertaken.
Eke
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Sophia Clinic, 27 Old Aba Road, P.O. Box 5575, Port Harcourt, Nigeria.
D006801:Humans; D006984:Hypertrophy; D007223:Infant; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011706:Pyloric Antrum / Q000601:surgery; D011707:Pyloric Stenosis / Q000151:congenital* / Q000601:surgery; D011859:Radiography; D012086:Reoperation