Fatal pneumoperitoneum caused by nasopharyngeal oxygen delivery after transoesophageal echocardiography for cardiac surgery.
We report a case of fatal post-operative pneumoperitoneum in a patient who had undergone urgent mitral valve surgery. In the absence of a proven cause of the pneumoperitoneum (refusal by the family of an autopsy), we can only propose a hypothesis for its origin. The most probable one is that forceful or sustained retrograde flexion of the transoesophageal echocardiographic probe created a lower oesophagus or gastric rupture and that oxygen flow administered by the nasal cannula went straight to the abdominal cavity, leading to tension pneumoperitoneum.
Mourissoux
G
G
Department of Anesthesia, Hôpital Foch, Suresnes, France.
Schlumberger
S
S
De Lentdecker
P
P
Fischler
M
M
D000368:Aged; D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D009305:Nasopharynx / Q000502:physiology*; D010100:Oxygen / Q000008:administration & dosage / Q000009:adverse effects*; D011027:Pneumoperitoneum / Q000209:etiology*; D012421:Rupture
D010100:Oxygen