Tension pneumoperitoneum in a child resulting from high-frequency oscillatory ventilation: a case report and review of the literature.
An 18-month-old male infant was placed on high-frequency oscillatory ventilation for profound hypoxemia and subsequently developed tension pneumoperitoneum. He underwent a bedside exploratory laparotomy for suspected perforated viscus. No intestinal perforation was identified, and a diagnosis of tension pneumoperitoneum secondary to pneumatosis cystoides intestinalis was made. To our knowledge, this is the only report of a pediatric patient developing tension pneumoperitoneum from high-frequency oscillatory ventilation. A review of the literature examines the differential diagnosis, physiology, and treatment of tension pneumoperitoneum.
Division of General Surgery, Department of Surgery, Weill Cornell Medical College, New York, NY 10021, USA. duh6776@gmail.com
Duncan B
DB
Hughes
Tanya N
TN
Judge
Nitsana A
NA
Spigland
D017668:Age of Onset; D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000628:therapy; D003937:Diagnosis, Differential; D004374:Ductus Arteriosus, Patent / Q000150:complications; D006612:High-Frequency Ventilation / Q000009:adverse effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D000860:Hypoxia / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000601:surgery / Q000628:therapy; D007416:Intestinal Perforation / Q000175:diagnosis; D059325:Intra-Abdominal Hypertension / Q000209:etiology*; D007813:Laparotomy; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology; D011006:Pneumatosis Cystoides Intestinalis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011027:Pneumoperitoneum / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011312:Pressure / Q000009:adverse effects; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000628:therapy; D012178:Retinopathy of Prematurity / Q000150:complications; D012422:Rupture, Spontaneous