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Tension pneumoperitoneum after cardiopulmonary resuscitation
P A Cameron1, P L Rosengarten, W R Johnson
1Alfred Hospital, Prahran, VIC.
Objective:
To increase awareness of the unusual complication of pneumoperitoneum after cardiopulmonary resuscitation.
Clinical Features:
A 57-year-old male farmer with a history of chronic renal failure and heart disease, as well as severe oesophageal reflux for which fundoplication had been performed, developed a tension pneumoperitoneum after cardiopulmonary resuscitation. This resulted in lower limb cyanosis and an erection, a previously unreported complication.
Intervention And Outcome:
The tension was relieved by uncapping a peritoneal dialysis catheter that was in situ. The cyanosis and erection resolved immediately, suggesting that the tension pneumoperitoneum had caused significant venous obstruction. A 3 cm defect in the posterior wall of the stomach was repaired.
Conclusion:
The likelihood of pneumoperitoneum is reduced if standard guidelines for cardiopulmonary resuscitation are adhered to.