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Gastric rupture with pneumoperitoneum after mouth-to-nose breathing in an infant

Katherine P O'Hanlon1

  • 1Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA.

The Journal of Emergency Medicine
|February 10, 2009
PubMed

Insights

Gastric rupture in infants, though rare, can result from resuscitative efforts. Prompt recognition and needle decompression are critical for treating tension pneumoperitoneum.

Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Emergency Medicine

Background:

  • Gastric rupture leading to tension pneumoperitoneum is a rare neonatal emergency.
  • It can be iatrogenically induced, sometimes during resuscitative maneuvers.

Observation:

  • A 16-week-old infant presented with respiratory distress and abdominal distention after a forceful nasal clearing attempt.
  • Physical examination revealed signs consistent with massive tension pneumoperitoneum.

Findings:

  • Needle aspiration successfully decompressed the tension pneumoperitoneum.
  • Laparotomy revealed and repaired a gastric laceration on the lesser curvature.

Implications:

  • This case highlights the importance of considering gastric rupture in infants with unexplained abdominal distention and respiratory distress.
  • Early recognition and intervention, including needle decompression, are vital for favorable outcomes in tension pneumoperitoneum.
Abstract

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