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Gastric rupture after bag-mask-ventilation.

Stephan Bednarz¹, Miodrag Filipovic¹, Otto Schoch²

¹Departement of Anesthesiology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland.

Respiratory Medicine Case Reports

|January 9, 2016

Summary

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Forceful bag-mask ventilation during bronchoscopy can cause stomach rupture due to air insufflation. This rare complication highlights the risks of positive pressure ventilation in sedated patients.

Area of Science:

Medical Procedures
Gastroenterology
Anesthesiology

Background:

Bronchoscopy is a common procedure requiring sedation.
Respiratory arrest can necessitate positive pressure ventilation.
Complications from airway management during sedation are critical.

Observation:

A patient undergoing bronchoscopy with propofol sedation experienced respiratory arrest.
Bag-mask ventilation led to abdominal distention and high inspiratory pressures.
Computed tomography revealed intraperitoneal free air, indicating a serious complication.

Findings:

An emergent laparotomy confirmed a stomach rupture.
Peak ventilatory pressures decreased immediately after the peritoneal cavity was opened.

Keywords:

Artificial Pneumoperitoneum

Related Experiment Videos

The case suggests forceful bag-mask ventilation caused gastric insufflation and rupture.

Implications:

Clinicians must be aware of the potential for gastric barotrauma during positive pressure ventilation.
Careful ventilation techniques are crucial to avoid iatrogenic injury in sedated patients.
Prompt recognition and surgical intervention are vital for managing stomach rupture.