A CASE OF PNEUMOPERITONEUM CAUSED BY RUPTURE OF THE LEFT MAIN BRONCHUS AFTER CARDIOPULMONARY RESUSCITATION

Abstract

The most common complications after cardiopulmonary resuscitation (CPR) are fractures of the ribs and sternum, but pneumoperitoneum after CPR is infrequent.
An 80-year-old man arrived at the hospital by an ambulance because of respiratory failure. He had been given intratracheal intubation in another hospital. During the transport to the hospital, external cardiac massage and artificial respiration by an Ambu bag were performed by an ambulance-man for 5 minutes. Subcutaneous emphysema was noted immediately after CPR. On admission, chest X-ray and CT examination showed subcutaneous emphysema, pneumomediastinum, retroperitoneal air and pneumoperitoneum. There were no pneumothoraces. Bronchoscopy demonstrated a mucosal disruption of the left main bronchus. We assumed that the rupture of the left main bronchus had occurred at the time of CPR and the air dissected to the mediastinum and retroperitoneal space and entered the peritoneal cavity.