Tension pneumoperitoneum following upper gastrointestinal endoscopy

Journal of the Formosan Medical Association = Taiwan Yi Zhi
Tsung-Chien LuShyr-Chyr Chen

Abstract

Tension pneumoperitoneum is a potentially lethal complication of numerous iatrogenic procedures, including upper gastrointestinal (UGI) endoscopy. We report a 69-year-old man with UGI bleeding who developed tension pneumoperitoneum and cardiac arrest after UGI endoscopy. He was successfully resuscitated with needle decompression. Emergency surgery revealed a perforated gastric ulcer, and subtotal gastrectomy with Billroth II anastomosis was performed. Recovery was smooth and he was discharged from the hospital 18 days later. Tension pneumoperitoneum should be suspected in all patients who develop circulatory collapse with acutely distended abdomen after UGI endoscopy. Early identification relies on a high index of suspicion. Prompt treatment with needle decompression should not be delayed for confirmatory radiography once the clinical diagnosis is made.

References

Jul 13, 2002·The Journal of Emergency Medicine·Ramy Yakobi-Shvili, David Cheng
Aug 6, 2002·Resuscitation·Julián Ortega-CarnicerFilomena Ceres
Apr 20, 2004·European Journal of Radiology·Roberto GrassiLuigia Romano

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Citations

Jan 16, 2013·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Nikolaos SymeonidisAthanasios Sakantamis
Jun 24, 2008·The Journal of Emergency Medicine·Brian W Lin, Wendy Thanassi
Dec 3, 2014·The Journal of Emergency Medicine·Yu-Guang ChenTzu-Chuan Huang
Nov 2, 2016·ANZ Journal of Surgery·Yiu Ming Ho
Nov 21, 2020·Journal of Surgical Case Reports·Catherine DenklerHani Seoudi

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