2019 Volume 39 Issue 6 Pages 1137-1140
A 69-year-old man was hospitalized elsewhere because of Parkinson’s disease. He was brought to our emergency room complaining of stridor and decreased oxygen saturation. A physical examination showed stridor, and laryngeal endoscopy revealed edema in the bilateral arytenoids with vocal cord paralysis. We performed tracheal intubation, and he was admitted to our hospital as an emergency. On the third day of hospitalization, we performed extubation but his respiratory condition became worse. We therefore performed reintubation with jet ventilation. His consciousness level subsequently decreased, and hypotension and abdominal distension appeared during reintubation. Computed tomography showed a perforation of the esophagogastric junction and a large amount of intraperitoneal free air. We diagnosed a tension pneumoperitoneum, and an abdominal puncture was carried out promptly. His abdomen was swiftly decompressed and systemic perfusion showed improvement. His course thereafter was good. We report herein on a rare case of tension pneumoperitoneum which was successfully treated with an abdominal puncture together with a review of the relevant literature.
