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J Korean Soc Emerg Med > Volume 16(1); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(1): 214-217.
Pneumoperitoneum Associated with Pneumomediastinum, Pneumothorax, Subcutaneous Empysema during Intubation and Positive Ventilation
Ki Ok Ahn, Yong Joo Lee
Department of Emergency Medicine, Seoul Adventist Hospital. arent1975@hanmail.net
ABSTRACT
Pneumoperitoneum associated with a pneumothorax, pneumomediastinum, and subcutaneous emphysema during intubation and positive ventilation has rarely been reported. In general, such a pneumoperitoneum requires conservative treatment; therefore, it should be distinguished from pneumoperitoneum associated with a hollow viscus perforation. Our case involved a 47-year-old man treated with intubation and positive ventilation for the maintenance of airway patency. Not only a pneumothorax, pneumomediastinum and subcutaneous emphysema but also free intra-abdominal gas was observed on the chest X-ray. No evidence of a hollow viscus perforation was found on physical examination and the upper gastrointestinal series. The patient was treated conservatively for 10 days; then, the pneumoperitoneum, the pneumothorax, the pnenumomediastinum, and the subcutaneous emphysema disappeared. In this report, we reviewed the clinical significance and the anatomical relation of pneumoperitoneum associated with a pneumothorax, pneumomediastinum, and subcutaneous emphysema.
Key words: Pneumoperitoneum, Pneumothorax, Pneumomediastinum, Intubation, Ventilation
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