Limits...
Tension Pneumoperitoneum Caused by Obstipation.

Miller D - West J Emerg Med (2015)

Bottom Line: Tension pneumoperitoneum (TP) is an uncommon condition with the potential to be rapidly fatal.It is amenable to prompt diagnosis and stabilization in the emergency department.We present a case of a 16-year-old boy with TP to demonstrate how TP should be incorporated into a differential diagnosis when evaluating an undifferentiated patient with AHC.

View Article: PubMed Central - PubMed

Affiliation: University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa.

ABSTRACT
Emergency physicians are often required to evaluate and treat undifferentiated patients suffering acute hemodynamic compromise (AHC). It is helpful to apply a structured approach based on a differential diagnosis including all causes of AHC that can be identified and treated during a primary assessment. Tension pneumoperitoneum (TP) is an uncommon condition with the potential to be rapidly fatal. It is amenable to prompt diagnosis and stabilization in the emergency department. We present a case of a 16-year-old boy with TP to demonstrate how TP should be incorporated into a differential diagnosis when evaluating an undifferentiated patient with AHC.

No MeSH data available.


Related in: MedlinePlus

Chest x-ray performed after needle decompression of abdomen demonstrating improved diaphragmatic excursion (black arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4644053&req=5

f3-wjem-16-777: Chest x-ray performed after needle decompression of abdomen demonstrating improved diaphragmatic excursion (black arrows).

Mentions: After noting massive pneumoperitoneum and elevation of the diaphragm we suspected tension pneumoperitoneum (TP) as the cause of shock. We positioned the patient in the right lateral decubitus position and placed three 14-gauge needles through the left abdominal wall, just lateral to the rectus musculature, and we advanced each needle until a rush of air was heard. As air was evacuated the patient’s abdominal distension visibly resolved. We soon noted decreased airway resistance and improved aeration. Within minutes the patient’s blood pressure improved to 93/47mmHg, and his pulse oximetry waveform became detectable at 93%. A repeat chest radiograph showed markedly improved pneumoperitoneum and diaphragmatic excursion with persistently dilated loops of bowel (Figure 3).


Tension Pneumoperitoneum Caused by Obstipation.

Miller D - West J Emerg Med (2015)

Chest x-ray performed after needle decompression of abdomen demonstrating improved diaphragmatic excursion (black arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644053&req=5

f3-wjem-16-777: Chest x-ray performed after needle decompression of abdomen demonstrating improved diaphragmatic excursion (black arrows).
Mentions: After noting massive pneumoperitoneum and elevation of the diaphragm we suspected tension pneumoperitoneum (TP) as the cause of shock. We positioned the patient in the right lateral decubitus position and placed three 14-gauge needles through the left abdominal wall, just lateral to the rectus musculature, and we advanced each needle until a rush of air was heard. As air was evacuated the patient’s abdominal distension visibly resolved. We soon noted decreased airway resistance and improved aeration. Within minutes the patient’s blood pressure improved to 93/47mmHg, and his pulse oximetry waveform became detectable at 93%. A repeat chest radiograph showed markedly improved pneumoperitoneum and diaphragmatic excursion with persistently dilated loops of bowel (Figure 3).

Bottom Line: Tension pneumoperitoneum (TP) is an uncommon condition with the potential to be rapidly fatal.It is amenable to prompt diagnosis and stabilization in the emergency department.We present a case of a 16-year-old boy with TP to demonstrate how TP should be incorporated into a differential diagnosis when evaluating an undifferentiated patient with AHC.

View Article: PubMed Central - PubMed

Affiliation: University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa.

ABSTRACT
Emergency physicians are often required to evaluate and treat undifferentiated patients suffering acute hemodynamic compromise (AHC). It is helpful to apply a structured approach based on a differential diagnosis including all causes of AHC that can be identified and treated during a primary assessment. Tension pneumoperitoneum (TP) is an uncommon condition with the potential to be rapidly fatal. It is amenable to prompt diagnosis and stabilization in the emergency department. We present a case of a 16-year-old boy with TP to demonstrate how TP should be incorporated into a differential diagnosis when evaluating an undifferentiated patient with AHC.

No MeSH data available.


Related in: MedlinePlus