Citation

Webman R, Rosenzweig M, Bholat O, Bernstein M, Todd SR, Frangos SG. Trauma (Sage) 2014; 16(1): 56-59.

Copyright

(Copyright © 2014, SAGE Publishing)

DOI

10.1177/1460408613507688

PMID

unavailable

Abstract

Tension pneumoperitoneum is a rare entity that occurs when free air under pressure accumulates in the abdominal cavity compromising visceral function and blood flow. The case of a 23-year-old man whose chest was run over by the wheels of a truck is presented. He arrived with a severely distended abdomen, significant thoracic trauma, hypoxemia, and elevated airway pressures following intubation. Imaging studies revealed massive intraperitoneal free air. He was treated with a decompressive laparotomy but was not found to have a hollow viscus nor diaphragmatic injury. We hypothesize a possible, as yet unpublished, mechanism: secondary to the patient's rib fractures and significant torso soft tissue shearing, a defect in the parietal pleura allowed air to track from the thorax inferiorly along subcutaneous and fascial planes, eventually entering into the peritoneal cavity through a violated parietal peritoneum. We present a review of the literature on tension pneumoperitoneum.

Language: en