Pneumoperitoneum complicating mechanical ventilator therapy

W. W. Turner, W. J. Fry

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Subdiaphragmatic air arouses the clinical suspicion of a perforated intra-abdominal viscus. In patients with respiratory failure requiring mechanical ventilation, the retroperitoneal dissection of air from the mediastinum may give rise to radiologic evidence of subdiaphragmatic emphysema. The present report describes four patients with this syndrome. In three of them, a perforated gastric or duodenal ulcer was initially suspected. None of these three patients underwent surgery. Autopsy examinations in two patients revealed extraperitoneal subdiaphragmatic emphysema with secondary rupture into the free peritoneal cavity. The third patient had an uneventful recovery and was discharged from the hospital. In a fourth patient, signs of peritonitis prompted an exploratory laparotomy. No perforation of an intraperitoneal viscus was identified. Upper gastrointestinal contrast roentgenography and peritoneal lavage may help determine the etiology of subdiaphragmatic air in patients undergoing therapy with a mechanical ventilator.

Original languageEnglish (US)
Pages (from-to)723-726
Number of pages4
JournalArchives of Surgery
Volume112
Issue number6
StatePublished - 1977

Fingerprint

Pneumoperitoneum
Mechanical Ventilators
Viscera
Air
Emphysema
Therapeutics
Peritoneal Lavage
Peritoneal Cavity
Mediastinum
Stomach Ulcer
Duodenal Ulcer
Peritonitis
Artificial Respiration
Radiography
Respiratory Insufficiency
Laparotomy
Dissection
Rupture
Autopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Pneumoperitoneum complicating mechanical ventilator therapy. / Turner, W. W.; Fry, W. J.

In: Archives of Surgery, Vol. 112, No. 6, 1977, p. 723-726.

Research output: Contribution to journalArticle

@article{e65246193d28407988c75a6dde4b9992,
title = "Pneumoperitoneum complicating mechanical ventilator therapy",
abstract = "Subdiaphragmatic air arouses the clinical suspicion of a perforated intra-abdominal viscus. In patients with respiratory failure requiring mechanical ventilation, the retroperitoneal dissection of air from the mediastinum may give rise to radiologic evidence of subdiaphragmatic emphysema. The present report describes four patients with this syndrome. In three of them, a perforated gastric or duodenal ulcer was initially suspected. None of these three patients underwent surgery. Autopsy examinations in two patients revealed extraperitoneal subdiaphragmatic emphysema with secondary rupture into the free peritoneal cavity. The third patient had an uneventful recovery and was discharged from the hospital. In a fourth patient, signs of peritonitis prompted an exploratory laparotomy. No perforation of an intraperitoneal viscus was identified. Upper gastrointestinal contrast roentgenography and peritoneal lavage may help determine the etiology of subdiaphragmatic air in patients undergoing therapy with a mechanical ventilator.",
author = "Turner, {W. W.} and Fry, {W. J.}",
year = "1977",
language = "English (US)",
volume = "112",
pages = "723--726",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Pneumoperitoneum complicating mechanical ventilator therapy

AU - Turner, W. W.

AU - Fry, W. J.

PY - 1977

Y1 - 1977

N2 - Subdiaphragmatic air arouses the clinical suspicion of a perforated intra-abdominal viscus. In patients with respiratory failure requiring mechanical ventilation, the retroperitoneal dissection of air from the mediastinum may give rise to radiologic evidence of subdiaphragmatic emphysema. The present report describes four patients with this syndrome. In three of them, a perforated gastric or duodenal ulcer was initially suspected. None of these three patients underwent surgery. Autopsy examinations in two patients revealed extraperitoneal subdiaphragmatic emphysema with secondary rupture into the free peritoneal cavity. The third patient had an uneventful recovery and was discharged from the hospital. In a fourth patient, signs of peritonitis prompted an exploratory laparotomy. No perforation of an intraperitoneal viscus was identified. Upper gastrointestinal contrast roentgenography and peritoneal lavage may help determine the etiology of subdiaphragmatic air in patients undergoing therapy with a mechanical ventilator.

AB - Subdiaphragmatic air arouses the clinical suspicion of a perforated intra-abdominal viscus. In patients with respiratory failure requiring mechanical ventilation, the retroperitoneal dissection of air from the mediastinum may give rise to radiologic evidence of subdiaphragmatic emphysema. The present report describes four patients with this syndrome. In three of them, a perforated gastric or duodenal ulcer was initially suspected. None of these three patients underwent surgery. Autopsy examinations in two patients revealed extraperitoneal subdiaphragmatic emphysema with secondary rupture into the free peritoneal cavity. The third patient had an uneventful recovery and was discharged from the hospital. In a fourth patient, signs of peritonitis prompted an exploratory laparotomy. No perforation of an intraperitoneal viscus was identified. Upper gastrointestinal contrast roentgenography and peritoneal lavage may help determine the etiology of subdiaphragmatic air in patients undergoing therapy with a mechanical ventilator.

UR - http://www.scopus.com/inward/record.url?scp=0017734806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017734806&partnerID=8YFLogxK

M3 - Article

C2 - 324438

AN - SCOPUS:0017734806

VL - 112

SP - 723

EP - 726

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 6

ER -