Gastric Rupture with Pneumoperitoneum after Mouth-To-Nose Breathing in an Infant

O'Hanlon, Katherine P.

doi:10.1016/j.jemermed.2008.09.019

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…In the one pediatric case identified, the father of a 16-week-old infant delivered a “large breath” through the infant’s nose in an effort to clear her nasal secretions, after which the infant’s abdomen became distended and she became short of breath. The resulting massive pneumoperitoneum produced an abdominal compartment syndrome that impaired the infant’s lung expansion, requiring emergent needle decompression 8 …”

Section: Discussionmentioning

confidence: 99%

“…2 In at least five of the seven previously reported cases of gastric perforation secondary to mouth-to-mouth rescue breathing, the bystander was a family member or friend. [2][3][4][5][6][7][8] It is plausible that such a person would inadvertently deliver excessively large and forceful rescue breaths, causing over-distension of the stomach and subsequent rupture.…”

Section: Discussionmentioning

confidence: 99%

“…The resulting massive pneumoperitoneum produced an abdominal compartment syndrome that impaired the infant's lung expansion, requiring emergent needle decompression. 8 Accordingly, it does not appear that prolonged mouth-to-mouth resuscitation is necessary to produce rupture. The father mentioned above delivered only one rescue breath; another patient developed a rupture after only two rescue breaths from her "husky son."…”

Section: Discussionmentioning

confidence: 99%

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On-Scene Rescue Breathing Resulting in Gastric Perforation and Massive Pneumoperitoneum

Butterfield

Peredy

2017

Prehosp. Disaster med.

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Rescue breathing performed too vigorously or by untrained individuals may cause gastric distension and perforation. A 26-year-old woman is presented who developed acute abdominal pain and distension after receiving rescue breathing following a heroin overdose. Massive pneumoperitoneum was seen on chest x-ray, and on subsequent laparotomy, a 4cm laceration was found in the lesser curvature of the stomach. Review of the literature suggests that the lesser curvature is particularly susceptible to perforation following over-distension. Emergency personnel should be aware of this rare, but serious, complication. Expansion of community and first responder naloxone use in the proper clinical setting may further diminish utilization of rescue breathing. Butterfield M , Peredy T . On-scene rescue breathing resulting in gastric perforation and massive pneumoperitoneum. Prehosp Disaster Med. 2017;32(6):682-683.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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On-Scene Rescue Breathing Resulting in Gastric Perforation and Massive Pneumoperitoneum

Butterfield

Peredy

2017

Prehosp. Disaster med.

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“…In pediatric patients tension pneumoperitoneum is a rare complication described after reduction of intussusceptions, mouth-to-mouth breathing, iatrogenic bowel perforations, and positive pressure ventilation. 1 – 4 It has not been described as a complication of non-accidental trauma. The increase in intra-abdominal pressure causes multiple physiologic derangements including decreased cardiac return via compression of the inferior vena cave and respiratory failure due to splinting of the diaphragms.…”

mentioning

confidence: 99%

“…Initial symptoms include abdominal pain and distension followed by hypoxia and shock. 1 – 4 Diagnosis is clinical, but radiographs will demonstrate free air and medial displacement of the solid organs and viscera.…”

mentioning

confidence: 99%