Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-06-02T14:10:41.629Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  03 July 2017

Mike Butterfield*
Affiliation:
Tampa General Hospital Department of Emergency Medicine, Tampa, FloridaUSA
Tamas Peredy
Affiliation:
Tampa General Hospital Department of Emergency Medicine, Tampa, FloridaUSA
*
Correspondence: Mike Butterfield, MD Tampa General Hospital Department of Emergency Medicine 1 Davis Boulevard, Suite 504 Tampa, Florida 33606 USA E-mail: mcbutterfield@gmail.com

Abstract

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.

ButterfieldM, PeredyT. On-Scene Rescue Breathing Resulting in Gastric Perforation and Massive Pneumoperitoneum. Prehosp Disaster Med. 2017;32(6):682–683.

Type
Case Reports
Copyright
© World Association for Disaster and Emergency Medicine 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest: none

References

1. Yamada, S, Nishimiya, J, Kurokawa, K, Yuasa, T, Masaka, A. Bilevel nasal positive airway pressure and ballooning of the stomach. Chest. 2001;119(6):1965-1966.Google Scholar
2. Wolff, AT, Hohenstein, C. Gastric perforation after mouth-to-mouth ventilation: a case report. Eur J Anaesthesiol. 2015;32(2):138-139.CrossRefGoogle ScholarPubMed
3. Valtonen, EJ, Hakola, N. Rupture of the normal stomach during mouth-to-mouth resuscitation. Report of a case. Acta Chir Scand. 1964;127:427-431.Google Scholar
4. Cassebaum, WH, Carberry, DM, Stefko, P. Rupture of the stomach from mouth-to-mouth resuscitation. J Trauma. 1974;14(9):811-814.Google Scholar
5. Solowiejczyk, M, Koren, E, Wapnick, S, Mandelbaum, J. Rupture of the stomach following mouth-to-mouth respiration. Postgrad Med J. 1974;50(590):769-772.Google Scholar
6. van Geel, AN, de Ruiter, P, Seerden, BP. [Stomach rupture caused by mouth-to-mouth respiration]. Ned Tijdschr Geneeskd. 1979;123(38):1647-1649.Google Scholar
7. Engelstein, D, Stamler, B. Gastric rupture complicating mouth-to-mouth resuscitation. Isr J Med Sci. 1984;20(1):68-70.Google ScholarPubMed
8. O’Hanlon, KP. Gastric rupture with pneumoperitoneum after mouth-to-nose breathing in an infant. J Emerg Med. 2010;39(3):312-315.Google Scholar
9. Schvadron, E, Moses, Y, Weissberg, D. Gastric rupture complicating inadvertent intubation of the esophagus. Can J Surg J Can Chir. 1996;39(6):487-489.Google Scholar
10. Smally, AJ, Ross, MJ, Huot, CP. Gastric rupture following bag-valve-mask ventilation. J Emerg Med. 2002;22(1):27-29.Google Scholar
11. Jarry, J, Hournau, M, Rault, A, Collet, D. [Gastric rupture secondary to non-invasive ventilation]. Gastroentérologie Clin Biol. 2009;33(6-7):492-493.Google Scholar
12. Bednarz, S, Filipovic, M, Schoch, O, Mauermann, E. Gastric rupture after bag-mask-ventilation. Respir Med Case Rep. 2015;16:1-2.Google Scholar
13. Song, JK, Stern, EJ, Beaty, CD. Gastric perforation: a complication of inadvertent esophageal intubation. AJR Am J Roentgenol. 1995;164(6):1386.Google Scholar
14. Spoormans, I, Van Hoorenbeeck, K, Balliu, L, Jorens, PG. Gastric perforation after cardiopulmonary resuscitation: review of the literature. Resuscitation. 2010;81(3):272-280.Google Scholar
15. McQueen, MM, Gollock, JM, Fergusson, RJ. Spontaneous gastric rupture complicating acute asthma. Br Med J Clin Res Ed. 1982;285(6343):692-693.Google Scholar
16. World Health Organization. Community Management of Opioid Overdose. Geneva, Switzerland: World Health Organization; 2014. http://www.ncbi.nlm.nih.gov/books/NBK264311/. Accessed January 6, 2017.Google Scholar