title: [Pneumoperitoneum and pneumomediastinum complicating non-invasive ventilation].
abstract: BACKGROUND
  Pneumoperitoneum is known to be a rare complication of invasive mechanical ventilation. However it has not previously been described as a consequence of non-invasive ventilation.
  
  
  METHODS
  The authors report a case of pneumoperitoneum associated with pneumomediastinum occurring in a 64-year-old patient treated for 3 years with bilevel ventilation via a nasal mask (expiratory pressure = 9 cm H2O, inspiratory pressure = 15 cm H2O) for obesity hypoventilation syndrome. Respiratory and gastroenterological investigations did not demonstrate a cause for this complication which resolved spontaneously following the cessation of ventilation. Nine months later, clinical deterioration and a worsening of blood gas parameters led to a recommencement of non-invasive mechanical ventilation at the same levels as previously. Over two years of follow up there have been no clinical or radiological signs of a recurrence of pneumomediastinum or pneumoperitoneum.
  
  
  CONCLUSIONS
  In the absence of any other explanation, barotrauma due to nasal ventilation appears to be the most likely explanation for this complication.
authors.affiliation: Service de Pneumologie, CHU de Poitiers, Poitiers, France.
authors.forename: D
authors.initials: D
authors.lastname: Planchard
authors.forename: M
authors.initials: M
authors.lastname: Verdaguer
authors.forename: V
authors.initials: V
authors.lastname: Levrat
authors.forename: F
authors.initials: F
authors.lastname: Caron
authors.forename: M
authors.initials: M
authors.lastname: Adoun
authors.forename: J C
authors.initials: JC
authors.lastname: Meurice
mesh_terms: D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000150:complications / Q000209:etiology*; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods