Pneumoperitoneum complicating mechanical ventilation in congenital myotonic dystrophy

Pneumoperitoneum is known as a disease caused by perforation of the gastrointestinal tract, but it has also been reported as a complication of mechanical ventilation. In a case of congenital myotonic dystrophy (CMyD), mechanical ventilation was performed to treat severe respiratory distress starting at birth, and then pneumomediastinum and pneumoperitoneum developed as complications 5 days after birth. The fact that the pneumoperitoneum improved when the ventilation pressure was reduced and the patient's course was observed, allowed us to rule out gastrointestinal perforation. It appeared that hypoplasia of the diaphragm may have been involved in the progression of pneumomediastinum to pneumoperitoneum in this patient. Mechanical ventilation is performed on many occasions in CMyD, and the development of pneumoperitoneum secondary to pulmonary air leak should always be borne in mind.