Journal of the Formosan Medical Association
Volume 105, Issue 5 , Pages 431-433, 2006

Tension Pneumoperitoneum Following Upper Gastrointestinal Endoscopy

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan

Received 2 May 2005; received in revised form 27 May 2005; accepted 5 July 2005.

Article Outline

Tension pneumoperitoneum is a potentially lethal complication of numerous iatrogenic procedures, including upper gastrointestinal (UGI) endoscopy. We report a 69-year-old man with UGI bleeding who developed tension pneumoperitoneum and cardiac arrest after UGI endoscopy. He was successfully resuscitated with needle decompression. Emergency surgery revealed a perforated gastric ulcer, and subtotal gastrectomy with Billroth II anastomosis was performed. Recovery was smooth and he was discharged from the hospital 18 days later. Tension pneumoperitoneum should be suspected in all patients who develop circulatory collapse with acutely distended abdomen after UGI endoscopy. Early identification relies on a high index of suspicion. Prompt treatment with needle decompression should not be delayed for confirmatory radiography once the clinical diagnosis is made.

Key Words:  gastrointestinal endoscopy , perforated peptic ulcer , tension pneumoperitoneum

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PII: S0929-6646(09)60142-X

doi:10.1016/S0929-6646(09)60142-X

Journal of the Formosan Medical Association
Volume 105, Issue 5 , Pages 431-433, 2006

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