J Korean Soc Emerg Med.  2005 Feb;16(1):214-217.

Pneumoperitoneum Associated with Pneumomediastinum, Pneumothorax, Subcutaneous Empysema during Intubation and Positive Ventilation

• Ahn KO
• Lee YJ

Abstract

Pneumoperitoneum associated with a pneumothorax, pneumomediastinum, and subcutaneous emphysema during intubation and positive ventilation has rarely been reported. In general, such a pneumoperitoneum requires conservative treatment; therefore, it should be distinguished from pneumoperitoneum associated with a hollow viscus perforation. Our case involved a 47-year-old man treated with intubation and positive ventilation for the maintenance of airway patency. Not only a pneumothorax, pneumomediastinum and subcutaneous emphysema but also free intra-abdominal gas was observed on the chest X-ray. No evidence of a hollow viscus perforation was found on physical examination and the upper gastrointestinal series. The patient was treated conservatively for 10 days; then, the pneumoperitoneum, the pneumothorax, the pnenumomediastinum, and the subcutaneous emphysema disappeared. In this report, we reviewed the clinical significance and the anatomical relation of pneumoperitoneum associated with a pneumothorax, pneumomediastinum, and subcutaneous emphysema.

Keyword

Pneumoperitoneum; Pneumothorax; Pneumomediastinum; Intubation; Ventilation

MeSH Terms

Humans
Intubation*
Mediastinal Emphysema*
Middle Aged
Physical Examination
Pneumoperitoneum*
Pneumothorax*
Subcutaneous Emphysema
Thorax
Ventilation*