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Med J Bakirkoy. 2009; 5(3): 113-116


A case with massive pneumoperitoneum due to mechanical ventilation

Meral Şen, Gökhan Akkurt, Ayhan Akpınar, Önder Sürgit, Mikdat Bozer.

Abstract
Pneumoperitoneum is used to describe the presence of free gas within the peritoneal cavity. In the majority of cases (85-90%) it is the result of perforation of an intrabdominal viscus and required emergency laparotomy. In the 10-15% of patients, there is no viscus perforation and this group is termed ‘nonsurgical’, ‘spontaneous’ or ‘idiopathic’ pneumoperitoneum. In this report we presented a 73-year-old woman who was admitted to the intensive care unit with respiratory failure due to chronic obstructive respiratory disease and pneumonia who developed masive pneumoperitoneum during mechanical ventilation.

Key words: Pneumoperitoneum, spontaneous, nonsurgical, idiopathic, mechanical ventilation



Mekanik ventilasyona bağlı gelişen masif pnömoperitoneum olgusu

Özet
Peritoneal boşlukta serbest hava bulunması olarak bilinen pnömoperitoneum, sıklıkla (%85-95) karın içi organ perforasyonları sonucu oluşur ve acil cerrahi tedavi gerektirir. Pnömoperitoneum görülen olguların %5-15’inde ise organ perforasyonu yoktur ve bu grup ‘cerrahi gerektirmeyen’, ‘spontan’ ya da ‘idiyopatik pnömoperitoneum’ olarak adlandırılır. Bu olgu sunumunda, kronik obstrüktif akciğer hastalığı (KOAH) zemininde gelişen pnömoniye bağlı solunum yetmezliği nedeni ile yoğun bakım ünitesine kabul edilen ve mekanik ventilasyon desteğinde iken masif pnömoperitoneum gelişen 73 yaşındaki kadın hastamızı sunuyoruz.

Anahtar Kelimeler: Spontan, idiyopatik, pnömoperitoneum, mekanik ventilasyon



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