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Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review

Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal p...

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Autores principales: Gummalla, Prabhavathi, Mundakel, Gratias, Agaronov, Maksim, Lee, Haesoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439261/
https://www.ncbi.nlm.nih.gov/pubmed/28567320
http://dx.doi.org/10.1155/2017/6907329
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author Gummalla, Prabhavathi
Mundakel, Gratias
Agaronov, Maksim
Lee, Haesoon
author_facet Gummalla, Prabhavathi
Mundakel, Gratias
Agaronov, Maksim
Lee, Haesoon
author_sort Gummalla, Prabhavathi
collection PubMed
description Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal perforation in a preterm neonate with respiratory distress syndrome who was on high frequency oscillatory ventilation (HFOV). He developed bilateral pulmonary interstitial emphysema with localized cystic lesion, likely localized pulmonary interstitial emphysema, and recurrent pneumothoraces. He was treated with dexamethasone to wean from the ventilator. Pneumoperitoneum developed in association with left sided pneumothorax following mechanical ventilation and cardiopulmonary resuscitation. Pneumoperitoneum resolved after the pneumothorax was resolved with chest tube drainage. He died from acute cardiorespiratory failure. At autopsy, there was no evidence of intestinal perforation. This case highlights the fact that pneumoperitoneum can develop secondary to pneumothorax and does not always indicate intestinal perforation or require exploratory laparotomy.
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spelling pubmed-54392612017-05-31 Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review Gummalla, Prabhavathi Mundakel, Gratias Agaronov, Maksim Lee, Haesoon Case Rep Pediatr Case Report Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal perforation in a preterm neonate with respiratory distress syndrome who was on high frequency oscillatory ventilation (HFOV). He developed bilateral pulmonary interstitial emphysema with localized cystic lesion, likely localized pulmonary interstitial emphysema, and recurrent pneumothoraces. He was treated with dexamethasone to wean from the ventilator. Pneumoperitoneum developed in association with left sided pneumothorax following mechanical ventilation and cardiopulmonary resuscitation. Pneumoperitoneum resolved after the pneumothorax was resolved with chest tube drainage. He died from acute cardiorespiratory failure. At autopsy, there was no evidence of intestinal perforation. This case highlights the fact that pneumoperitoneum can develop secondary to pneumothorax and does not always indicate intestinal perforation or require exploratory laparotomy. Hindawi 2017 2017-04-16 /pmc/articles/PMC5439261/ /pubmed/28567320 http://dx.doi.org/10.1155/2017/6907329 Text en Copyright © 2017 Prabhavathi Gummalla et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Gummalla, Prabhavathi
Mundakel, Gratias
Agaronov, Maksim
Lee, Haesoon
Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review
title Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review
title_full Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review
title_fullStr Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review
title_full_unstemmed Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review
title_short Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review
title_sort pneumoperitoneum without intestinal perforation in a neonate: case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439261/
https://www.ncbi.nlm.nih.gov/pubmed/28567320
http://dx.doi.org/10.1155/2017/6907329
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