Gastric rupture: a danger of postoperative oxygenation with a nasal catheter

On the fifth postoperative day after pulmonary lobectomy, a 64-year-old man accidentally connected his nasal catheter (providing six liters of oxygen per minute) to his nasogastric tube. Tension pneumoperitoneum occurred with acute respiratory distress. Gastric rupture occurring during cardio-pulmonary resuscitation has been reported several times. Our case illustrates another unusual cause of tension pneumoperitoneum. Emergency percutaneous decompression was effected with needle aspiration, followed by laparotomy for gastric repair covered by an omental flap.