title: Airway management: induced tension pneumoperitoneum.
abstract: Pneumoperitoneum is not always associated with hollow viscus perforation. Such condition is called non-surgical or spontaneous pneumoperitoneum. Intrathoracic causes remain the most frequently reported mechanism inducing this potentially life threatening complication. This clinical condition is associated with therapeutic dilemma. We report a case of a massive isolated pneumoperitoneum causing acute abdominal hypertension syndrome, in a 75 year female, which occurred after difficult airway management and mechanical ventilation. Emergent laparotomy yielded to full recovery. The recognition of such cases for whom surgical management can be avoided is primordial to avoid unnecessary laparotomy and its associated morbidity particularly in the critically ill.
authors.affiliation: Medical Intensive Care Unit, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Khedher
authors.initials: K
authors.lastname: Ahmed
authors.affiliation: General Surgery Department, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: El Ghali Mohamed
authors.initials: EG
authors.lastname: Amine
authors.affiliation: Medical Intensive Care Unit, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Azouzi
authors.initials: A
authors.lastname: Abdelbaki
authors.affiliation: Medical Intensive Care Unit, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Ayachi
authors.initials: A
authors.lastname: Jihene
authors.affiliation: Medical Intensive Care Unit, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Meddeb
authors.initials: M
authors.lastname: Khaoula
authors.affiliation: Medical Intensive Care Unit, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Hamdaoui
authors.initials: H
authors.lastname: Yamina
authors.affiliation: Medical Intensive Care Unit, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Boussarsar
authors.initials: B
authors.lastname: Mohamed
mesh_terms: D000208:Acute Disease; D000368:Aged; D058109:Airway Management / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000209:etiology*; D007813:Laparotomy / Q000379:methods; D011027:Pneumoperitoneum / Q000150:complications / Q000209:etiology* / Q000601:surgery; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods
keywords: Non-surgical pneumoperitoneum; acute abdominal compartment syndrome; barotraumas