Gastric rupture during fiberoptic bronchoscopy, a rare complication of oxygen administration by nasopharyngeal cannula: a case report

Abstract Concomitant use of a nasopharyngeal catheter is frequently used for oxygen supply during fiberoptic bronchoscopy (FOB). This is a procedure that presents possible complications that are not negligible. We demonstrate the case of a 61-year-old woman who underwent FOB due to a history of hemoptoic sputum. During the procedure, gastric rupture occurred with a large pneumoperitoneum and bilateral pneumothorax requiring immediate drainage of the air and an emergent laparotomy. This was probably a complication of the nasopharyngeal catheter. The knowledge of these complications is essential for their correct identification and treatment.

Ruptura gástrica por mecanismo de bolsa de papel por trauma cerrado de abdomen. Reporte de un caso / Gastric rupture due to paper bag mechanism because of a closed abdominal trauma. A case report

Resumen A pesar de que el trauma abdominal contuso es una entidad frecuente, su asociación con lesión gástrica es rara (aproximadamente 1.7%); sin embargo, es una posibilidad que siempre debe considerarse durante su evaluación. Además de su trascendencia como hallazgo aislado, es esencial su correlación con otras lesiones. Presentamos el siguiente caso no sólo por la escasa frecuencia con la que se observan este tipo de lesiones, sino por sus características clínicas anómalas, las cuales -salvo por el mecanismo del trauma- hicieron prácticamente imposible su sospecha.

Abstract Although closed abdominal trauma is a frequent entity, its association with gastric injury is rare (approximately a 1.7%); however, it is a possibility that should always be taken into consideration during its evaluation. In addition to its transcendence as an isolated finding, its correlation with other lesions is essential. We present the following case not only because of the low frequency with which these sort of lesions are observed, but also because of its anomalous clinical features that make any suspicion virtually impossible, except for the mechanism of the trauma.

Ruptura gástrica. Informe de un caso / Gastric rupture. Case report

Resumen La expresión abdomen agudo en pediatría implica el concepto de una emergencia médica de origen abdominal. En los primeros días de la vida, las anomalías digestivas congénitas (presentes en aproximadamente 1 de cada 5000 recién nacidos) constituyen la causa más importante de abdomen agudo. La ruptura gástrica es un cuadro que puede describirse como causa de catástrofe intraabdominal, pudiendo ocasionar shock y muerte del paciente. Este trabajo describe un caso de ruptura gástrica espontánea en un niño de tres años de edad, con cuadro clínico de más o menos 12 horas de evolución, consistente en dolor abdominal asociado a náuseas, distensión abdominal. La madre refirió que no ha había deposiciones ni flatos. Ecografía abdominal reportó abundante líquido en cavidad abdominal. El niño fue llevado a quirófano y falleció.

Abstract The expression acute abdomen in pediatrics, implies the concept of a medical emergency of abdominal origin. In the first days of life, congenital digestive abnormalities (those present in about 1 in 5000 infants) are the most important cause of acute abdomen. Gastric rupture is a condition that can be described as the cause of intra-abdominal cataracts, which can cause shock and death of the patient. This paper describes a case of spontaneous gastric rupture in a 3-year-old boy with a clinical picture of about 12 hours of evolution consisting of abdominal pain associated with nausea, abdominal distension, the mother who has not had bowel movements Abdominal ultrasound reports abundant fluid in the abdominal cavity, which is taken to the operating room and dies.

A Case of Gastric Rupture after Cardiopulmonary Resuscitation by a Bystander

The presence of a bystander who can implement cardiopulmonary resuscitation would appear to increase chances of survival. However, there have been many reported complications associated with bystander CPR. Gastric rupture is a rare complication following cardiopulmonary resuscitation. An incidence of 0.1% has been reported in the literature. The majority of reported cases have been associated with inappropriate airway management or esophageal intubation. Gastric rupture can occur during chest compressions when the stomach is overinflated due to difficult airway management or esophageal intubation. Here we present the case of a patient with sudden cardiac arrest who experienced gastric rupture and pneumoperitoneum after bystander cardiopulmonary resuscitation.

Ruptura gástrica por reanimação cardiopulmonar: relato de caso / Gastric rupture following cardiopulmonary resuscitation: case report

JUSTIFICATIVA E OBJETIVOS: A ruptura gástrica é uma rara complicação das manobras de reanimação cardiopulmonar (RCP), com incidência de 0,1 por cento dos casos. O desconhecimento dessa possível complicação durante essas manobras impede sua identificação e reduz a probabilidade de sobrevivência do paciente. O objetivo deste trabalho foi abordar um caso de abdômen agudo por ruptura gástrica após manobra de RCP, prontamente diagnosticada e tratada. RELATO DO CASO: Paciente do sexo feminino, de 76 anos, internada em caráter de urgência com diagnóstico inicial de pneumonia e acidente vascular encefálico. Evoluiu com quadro de insuficiência respiratória e parada cardiorrespiratória (PCR), a qual foi prontamente revertida através de manobras de RCP. Apesar da reversão da PCR, reanimação volêmica adequada, suporte com vasopressores e melhora respiratória após suporte ventilatório, a paciente permaneceu com quadro hemodinâmico instável. O exame físico revelou diminuição da macicez hepática e distensão abdominal. A radiografia de tórax evidenciou presença de pneumoperitônio. Diagnóstico de abdômen agudo perpetuando a instabilidade hemodinâmica foi pressuposto, sendo a paciente, então, encaminhada à cirurgia de emergência com hipótese diagnóstica de ruptura gástrica traumática, evidenciada macroscopicamente e confirmada por análise histopatológica da peça cirúrgica. CONCLUSÕES: No caso relatado, o pronto diagnóstico e o tratamento adequado de emergência levaram ao prognóstico favorável. Ressalta-se a importância do conhecimento dessa possível complicação com ênfase na realização do exame físico além da monitorização e vigília do paciente após PCR. Constante atualização do ensino das técnicas adequadas de RCP através de programas de educação médica continuada é crucial para que manobras incorretas sejam evitadas.

BACKGROUND AND OBJECTIVES: Gastric rupture is a rare complication from cardiopulmonary resuscitation (CPR), with a reported incidence of 0.1 percent. Unawareness of this possible complication during these maneuvers delays its recognition and reduces the patientÆs surviving chance. The aim of this report is to describe a case of acute abdomen due to gastric rupture following CPR maneuvers that was promptly diagnosed and treated. CASE REPORT: We report a case of a 76-year-old patient that was admitted to the hospital with pneumonia and also to rule out a possible brain vascular accident (BVA). In the first day after admission she developed acute respiratory failure and cardiac arrest, being successfully resuscitated and subsequently transferred to the intensive care unit (ICU) by the medical ward team. Despite successful CPR, adequate volume resuscitation, vasopressor support and respiratory function improvement she remained with significant hemodynamic instability. Physical examination hours after CPR showed a hypertimpanic liver percussion, abdominal distension, tachycardia and hypotension. Chest X-Ray revealed pneumoperitoneum, and gastric perforation was identified by an exploratory laparotomy. Histopathology confirmed traumatic gastric injury. CONCLUSIONS: We report a rare case of traumatic gastric rupture after CPR maneuvers in which prompt diagnosis and emergent treatment lead to a favorable outcome. This case brings out the need to increase awareness of this life-threatening complication with emphasis on the importance of a thorough physical examination after CPR maneuvers. Reinforcement of appropriate CPR technique is crucial to avoid incorrect maneuvers through continued medical education.

Gasric Rupture as the Result of a Binge-Eating after a Abstinence Prayer

Spontaneous gastric rupture is a very rare disease and may be related to the consumption of large meals. We experienced a rare case of gastric rupture due to binge eating. A 57-year-old woman visited the emergency department with an abdominal distention following binge eating after a two day abstinence prayer. A plain abdominal X-ray showed free air in the subphrenic space and a markedly distended stomach. At laparotomy, the stomach was dilatated and ruptured about 7 cm from the esophagogastric junction to the lesser curvature. A total gastrectomy was done, but at 11 days, the patient expired due to sepsis. Causes of acute gastric dilatation are various and include binge eating. Massive gastric dilatation leads to a decrease in intramural blood flow and gastric infarction. Symptoms of gastric dilatation may be mild, but are progressive. Diagnosis can be made by observing free air or a distended stomach on a simple abdominal X-ray. Treatment should begin with nasogastric decompression and fluid resuscitation. If conservative treatment fails or if gastric infarction or perforation is suspected, surgical intervention is mandatory.

A Case of Gastric Rupture and Pneumoperitoneum after Cardiopulmonary Resuscitation in Acute Myocardial Infarction

Latrogenic gastric rupture is a rarely reported complication of cardiopulmonary resuscitation. Rupture can occur during chest compressions when the stomach is overinflated due to difficult airway management or esophageal intubation. The prognosis of gastric rupture is generally poor, so patients should undergo surgical treatment as soon as possible. We present the case report of a patient with an acute myocardial infarction who experienced gastric perforation and pneumoperitoneum after cardiopulmonary resuscitation.

Gastric Rupture after Failed Intubation for Cesarean Section / 대한마취과학회지

A 27-year-old parturient in her gestational age of 38(+4) weeks was admitted to the obstetric emergency room due to fetal distress and suspected pneumoperitoneum after a failed intubation during anesthetic induction for cesarean delivery, which occurred at an obstetric clinic. On admission, she was drowsy, her abdomen was excessively distended, and the fetal heart tone was inaudible. An emergency cesarean section was performed after a standard laryngeal mask airway (size 4) was inserted for general anesthesia. At the moment the peritoneum was opened, a great amount of free air escaped. A floppy baby was delivered with an Apgar score 1 at 1 min and 4 at 5 min. Before transfer to the neonatal intensive care unit, the baby was resuscitated and intubated. Immediately after the cesarean section was completed, an emergency exploratory laparotomy was carried out. During the laparotomy, a linear tear, 8.2 cm long, along the lesser curvature of stomach was identified and repaired. The patient and her baby recovered uneventfully and were dischargedon the 7(th) postoperative day.