Tension pneumoperitoneum after cardiopulmonary resuscitation

Abstract

Objective: To increase awareness of the unusual complication of pneumoperitoneum after cardiopulmonary resuscitation.

Clinical features: A 57-year-old male farmer with a history of chronic renal failure and heart disease, as well as severe oesophageal reflux for which fundoplication had been performed, developed a tension pneumoperitoneum after cardiopulmonary resuscitation. This resulted in lower limb cyanosis and an erection, a previously unreported complication.

Intervention and outcome: The tension was relieved by uncapping a peritoneal dialysis catheter that was in situ. The cyanosis and erection resolved immediately, suggesting that the tension pneumoperitoneum had caused significant venous obstruction. A 3 cm defect in the posterior wall of the stomach was repaired.

Conclusion: The likelihood of pneumoperitoneum is reduced if standard guidelines for cardiopulmonary resuscitation are adhered to.