Tension pneumoperitoneum: Case report of a rare form of acute abdominal compartment syndrome

Manuel Cadena,Jaime Solano,Nicolas Caycedo,Daniel Gomez,Eric E Vinck,Pedro Quiroga,Paula Gaete

doi:10.1016/j.ijscr.2019.01.014

Abstract

Introduction: Tension pneumoperitoneum is a severe and rare form of pneumoperitoneum with concomitant hemodynamic instability and respiratory failure. It is a variant of abdominal compartment syndrome (ACS) causing an abrupt increase in intra-abdominal pressure.Presentation of case: We present a case of pneumoperitoneum, after an endoscopic mucosal resection with the development of ACS. The patient was successfully treated with percutaneous decompression.Discussion: Decompressive laparotomy is the first treatment option for both most forms of pneumoperitoneum and ACS; nevertheless, this issue is controversial. Recent reports have shown that some patients may be candidates for a minimally invasive catheter decompression avoiding major decompressive surgery. Identifying these patients is vital to avoiding unnecessary surgeries.Conclusions: Tension pneumoperitoneum is a life-threatening event, early detection and intervention is critical in order to provide prompt and optimal treatment approaches.

Highlights

Tension pneumoperitoneum is a severe and rare form of pneumoperitoneum with concomitant hemodynamic instability and respiratory failure
To seed the suspicion of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in surgeons, anesthesiologists, intensivists and general practitioners; we present a case that highlights the burden, clinical presentation and spectrum of etiologies of elevated intra-abdominal pressure (IAP) syndromes
We present a case of abdominal compartment syndrome (ACS) induced by pneumoperitoneum after an endoscopic mucosal resection

Summary

Introduction

Tension pneumoperitoneum is a severe and rare form of pneumoperitoneum with concomitant hemodynamic instability and respiratory failure. It is a variant of abdominal compartment syndrome (ACS) causing an abrupt increase in intra-abdominal pressure. Presentation of case: We present a case of pneumoperitoneum, after an endoscopic mucosal resection with the development of ACS. The patient was successfully treated with percutaneous decompression

Discussion

Background

Case report

Findings

Conclusions

Ethical approval