Pneumoperitoneum developing after cardiopulmonary resuscitation may result either from visceral organ perforation or passage of mediastinal air via the diafragmatic hiatus of esophageus and aorta or directly through pleural and diafragmatic defects. A 77-year-old female patient was transferred to intensive care unit due to respiratory failure developing after coronary bypass surgery. Massive subcutaneous emphysema developed after tracheostomy. Tracheostomy cannula, therefore, was removed, and the patient was reintubated. Later acute cardiac arrest developed, and cardiopulmonary resuscitation was performed. Free air was detected below both diaphragms on chest radiograph. Conservative treatment was performed in the patient without peritoneal irritation signs or abdominal free fluid. Subdiaphragmatic free air completely disappeared after four days.
Cardiopulmonary resuscitation, coronary bypass, pneumoperitoneum