Gastric perforation following cardiopulmonary resuscitation
- PDF / 776,534 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 24 Downloads / 208 Views
IMAGING IN INTENSIVE CARE MEDICINE
Gastric perforation following cardiopulmonary resuscitation Ashish Verma1 , Muhammad Hassaan Shahid1 and John Wesley Boldt Jr.2* © 2018 Springer-Verlag GmbH Germany, part of Springer Nature and ESICM
A 52-year-old woman with a history of hypertension and depression was found hanging on the porch by her boyfriend. She was taken down, and the boyfriend started cardiopulmonary resuscitation (CPR). The patient achieved a return of spontaneous circulation on emergency medical services arrival. The patient was not able to protect her airway, hence was intubated. Vital signs were stable. Gastric distension was noted on physical examination. A nasogastric tube was inserted to decompress the distension. Portable chest X-ray (Fig. 1a) was done showing pneumoperitoneum. To further evaluate, non-contrast-enhanced computer tomography (CT) of
the chest, abdomen, and pelvis was done to evaluate the gastric distension refractory to nasogastric tube insertion. CT of the chest, abdomen, and pelvis (Fig. 1b, c) showed large volume pneumoperitoneum compressing on the abdominal viscera. Following this finding emergent surgical consult was made. The patient was taken to surgery. Exploratory laparotomy showed gastric perforation at the level of lesser curvature of the stomach, and partial gastrectomy was done. The patient recovered adequately after surgery and was discharge for rehabilitation. Gastric perforation was attributed to aggressive chest compression leading to impingement of stomach
Fig. 1 a Portable chest X-ray AP view showing (arrow) pneumoperitoneum. b Computer tomography of the chest, abdomen, and pelvis sagittal view showing (arrow) large volume pneumoperitoneum extending below diaphragm to the level of pelvis. c Computer tomography of the chest and abdomen axial view showing large volume pneumoperitoneum (arrow) pressing on the abdominal viscera
*Correspondence: [email protected] 2 Department of Pulmonary and Critical Care Medicine, University of Tennessee College of Medicine, 979 East Third Ave Suite C 735, Chattanooga, TN 37403, USA Full author information is available at the end of the article
between xiphoid and spine with forceful mouth to mouth breathing with wrong airway positioning. Author details 1 Department of Medicine, University of Tennessee College of Medicine, Chattanooga, USA. 2 Department of Pulmonary and Critical Care Medicine, University of Tennessee College of Medicine, 979 East Third Ave Suite C 735, Chattanooga, TN 37403, USA.
Compliance with ethical standards Conflicts of interest All the authors have no conflict of interest. Received: 6 April 2018 Accepted: 11 April 2018
Data Loading...
