Citation

Curfman KR, Robitsek RJ, Sammett D, Schubl SD. J. Surg. Case Rep. 2015; 2015(12): e147.

Affiliation

Department of Surgery, Jamaica Hospital Medical Center, Jamaica, NY, USA jrobitse@jhmc.org.

Copyright

(Copyright © 2015, Oxford University Press)

DOI

10.1093/jscr/rjv147

PMID

26628715

PMCID

PMC4664951

Abstract

Here, we present a case of pneumoperitoneum caused by traumatic pneumothorax after a fall. The patient is an 82-year-old male who was brought into the emergency department after being found at the bottom of a flight of stairs with a bleeding scalp laceration. Upon presentation, the patient underwent emergent intubation followed by tube thoracostomy placement, had necessary imaging and was transferred to the surgical intensive care unit (SICU). Imaging revealed signs of pneumomediastinum and pneumoperitoneum in addition to the partially resolved pneumothorax. In the SICU, the patient became hemodynamically unstable requiring vasopressor support, which in the face of documented pneumoperitoneum without a clear cause mandated exploration. He was taken to the operating room for suspected viscus perforation, though none was found after extensively searching during an exploratory laparotomy. We suspect the patient developed pneumomediastinum and pneumoperitoneum as a result of traumatic pneumothorax, hastened by his subsequent intubation and mechanical ventilation.

Language: en