Pneumoperitoneum. A complication of mechanical ventilation

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Pulmonology

Background:

• Pneumoperitoneum, characterized by free air in the abdominal cavity, is typically associated with visceral perforation.
• Mechanical ventilatory support is a cornerstone of critical care for respiratory failure.

Observation:

• Three adult patients receiving mechanical ventilation developed pneumoperitoneum.
• Standard diagnostic methods, including clinical evaluation, surgical exploration, and autopsy, did not confirm visceral perforation in these cases.

Findings:

• The presence of free abdominal air was attributed to a complication of mechanical ventilatory therapy.
• This suggests a potential link between positive-pressure ventilation and the development of pneumoperitoneum.

Implications:

• Pneumoperitoneum secondary to mechanical ventilation may be an underdiagnosed condition.
• Clinicians should consider ventilatory-associated pneumoperitoneum in the differential diagnosis for patients on mechanical support, even without clear signs of perforation.