Gastric Rupture with Pneumoperitoneum after Mouth-To-Nose Breathing in an Infant

Abstract Background: Gastric rupture with resulting tension pneumoperitoneum occurs rarely in infants. It may be associated with resuscitative efforts. Objectives: This report presents a unique case of gastric rupture and illustrates the factors necessary for prompt recognition and treatment. Case R...

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Bibliographic Details
Published in:The Journal of emergency medicine 2010-09, Vol.39 (3), p.312-315
Main Author: O'Hanlon, Katherine P., MD
Format: Article
Language:English
Subjects:
abdominal compartment syndrome
Emergency
Female
gastric rupture
Humans
Infant
Insufflation - adverse effects
mouth-to-nose breathing
nasal obstruction
Pneumoperitoneum - diagnosis
Pneumoperitoneum - etiology
Pneumoperitoneum - therapy
Stomach Rupture - diagnosis
Stomach Rupture - etiology
Stomach Rupture - surgery
tension pneumoperitoneum
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Summary:Abstract Background: Gastric rupture with resulting tension pneumoperitoneum occurs rarely in infants. It may be associated with resuscitative efforts. Objectives: This report presents a unique case of gastric rupture and illustrates the factors necessary for prompt recognition and treatment. Case Report: The patient was a 16-week-old infant with nasal congestion whose father had attempted to clear her nose by a mouth-to-mouth-and-nose maneuver. The alert and attentive patient presented to the Emergency Department in respiratory distress, with marked abdominal distention. She was diagnosed with a massive tension pneumoperitoneum, which was decompressed by needle aspiration. A laceration of the lesser curvature of the stomach was repaired at laparotomy; the patient recovered uneventfully. Conclusion: Tension pneumoperitoneum is rarely seen but has key defining elements. A simple procedure is critical to relief of the condition.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2008.09.019