Abstract
A 16-year-old girl is admitted to the hospital with increasing abdominal pain. Her history is unremarkable and she is on no treatment. A diagnosis of a perforated viscous is made. Abdominal X-rays show a large pneumoperitoneum with elevation of the diaphragm. She is transferred to the operating room with a 4-l oxygen mask for an emergency laparotomy. She is unable to lie flat because of her respiratory distress. Her vital signs include a sinus tachycardia of 110 beats per minute (bpm), blood pressure (BP) 150/90, respiration shallow with a rate of 32, and oxygen saturation 95 %. She complains of severe abdominal pain, cannot get enough air, and is very worried.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Dow TGB, Chamney AR, Wraight WJ, Simons RS. The application of cricoid pressure: an assessment and a survey of its practice. Anaesthesia. 1983;38:457–60.
Brock-Utne JG, Dow TG, Welman S, Dimopoulos GE, Moshal MG. The effect of metoclopramide on the lower oesophageal sphincter in late pregnancy. Anaesth Intensive Care. 1978;6:26–9.
Andrews AD, Brock-Utne JG, Downing JW. Protection against pulmonary acid aspiration with ranitidine. Anaesthesia. 1982;37:22–5.
Brock-Utne JG, Downing JW, Humphrey D. Effect of ranitidine given before atropine sulphate on lower esophageal sphincter tone. Anaesth Intensive Care. 1984;12:140–2.
Brock-Utne JG. Domperidone antagonizes the relaxant effect of atropine on the lower esophageal sphincter. Anesth Analg. 1980;59:921–4.
Howard FA, Sharp DS. Effects of metoclopramide on gastric emptying during labour. BMJ. 1973;1:446–8.
Murphy DF, Nally B, Gardiner J. Effect of metoclopramide on gastric emptying before elective emergency caesarean section. Br J Anaesth. 1984;56:1113–6.
Raidoo DM, Rocke DA, Brock-Utne JG, Marszalek A, Engelbrecht HE. Critical volume for pulmonary aspiration. Reappraisal in a primate model. Br J Anaesth. 1990;65:248–50.
Howells THE, Chamney AR, Wraight WJ, Simons RS. The application of cricoid pressure: an assessment and a survey of its practice. Anaesthesia. 1983;38:457–60.
Wraight WJ, Chamney AR, Howells THE. The determination of an effective cricoid pressure. Anaesthesia. 1983;38:461–6.
Critchley LAH, Rowbottom S. Fatal tension pneumoperitoneum with pneumothorax. Anaesth Intensive Care. 1994;22:298–9.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Brock-Utne, J.G. (2013). Case 18: Tension Pneumoperitoneum. In: Near Misses in Pediatric Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7040-3_18
Download citation
DOI: https://doi.org/10.1007/978-1-4614-7040-3_18
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-7039-7
Online ISBN: 978-1-4614-7040-3
eBook Packages: MedicineMedicine (R0)