title: Gastric rupture with pneumoperitoneum after mouth-to-nose breathing in an infant.
abstract: BACKGROUND
  Gastric rupture with resulting tension pneumoperitoneum occurs rarely in infants. It may be associated with resuscitative efforts.
  
  
  OBJECTIVE
  This report presents a unique case of gastric rupture and illustrates the factors necessary for prompt recognition and treatment.
  
  
  METHODS
  The patient was a 16-week-old infant with nasal congestion whose father had attempted to clear her nose by a mouth-to-mouth-and-nose maneuver. The alert and attentive patient presented to the Emergency Department in respiratory distress, with marked abdominal distention. She was diagnosed with a massive tension pneumoperitoneum, which was decompressed by needle aspiration. A laceration of the lesser curvature of the stomach was repaired at laparotomy; the patient recovered uneventfully.
  
  
  CONCLUSIONS
  Tension pneumoperitoneum is rarely seen but has key defining elements. A simple procedure is critical to relief of the condition.
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: O'Hanlon
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007327:Insufflation / Q000009:adverse effects*; D011027:Pneumoperitoneum / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013275:Stomach Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery