Rare case of pneumoperitoneum in nonintubated COVID‐19 patient

Abstract

We report a rare case of a 50‐year‐old female patient with COVID‐19 presented to the emergency department where supplementary oxygen is delivered via noninvasive face mask ventilation. X‐ray imaging confirmed the existence of pneumoperitoneum. CT scan was not applicable due to the advanced status of the patient.

Rare case of pseudo-pneumoperitoneum as a triad of extensive subcutaneous emphysema and pneumomediastinum as a complication of non-invasive respiratory support

“…BiPap and CPAP were used for respiratory support in all instances of pneumoperitoneum reviewed for this case. 2,[12][13][14][15][16][17] HFNC use has been associated with PMN/SE; however, it is theorized HFNC is a better modality of respiratory support in these patients as it exerts minimal positive end-expiratory pressure (PEEP), decreasing alveolar overdistension and self-inflicted lung injury. 7,9 The positive correlation of higher PEEP with PMN/SE has been observed clinically with patients receiving more aggressive pressure support demonstrating increased complications from NIV.…”

“…1,7 PMN and SE are becoming a more recognized complication of non-invasive respiratory support with the onset of the novel SARS-CoV-19 (COVID-19) global pandemic due to frequent occurrence of AHRF in infected patients along with the extensive pulmonary inflammatory changes . 3,[8][9][10][11][12] The much rarer phenomenon of spontaneous pneumoperitoneum has been documented in only several cases. 2,[12][13][14][15][16][17] We present a case of a pseudo-pneumoperitoneum associated with non-invasive respiratory support, but uniquely, as part of a triad of pneumomediastinum with extensive subcutaneous emphysema extending circumferentially around the abdomen and down into the scrotum.…”

“…3,[8][9][10][11][12] The much rarer phenomenon of spontaneous pneumoperitoneum has been documented in only several cases. 2,[12][13][14][15][16][17] We present a case of a pseudo-pneumoperitoneum associated with non-invasive respiratory support, but uniquely, as part of a triad of pneumomediastinum with extensive subcutaneous emphysema extending circumferentially around the abdomen and down into the scrotum. To our knowledge, this has not been described elsewhere.…”