Spontan pnömoperitoneuma baðlý abdominal kompartman sendromunun yatak baþý dekompresyonu: Nadir bir olgu

Pnömoperitoneum periton boþluðunda serbest hava bulunmasýdýr. Gastrointestinal sistem perforasyonunun bir bulgusudur. Ancak perforasyon olmadanda gözlenir. Bu durum spontan pneumoperitonium olarak adlandýrýlýr. Elli yedi yaþýnda solunum yetersizliði nedeniyle entübe edilerek mekanik ventilasyona baþlanan kadýn hastamýzda massif spontan pnömoperitoneum ve buna baðlý abdominal kompartman sendromu geliþti. Hastaya peritoneal lavajla hem dekompresyon yapýldý hemde taný desteklendi. Spontan pneömoperitoneumda farkýndalýðýn az olmasý nedeniyle çoðu cerrah refleks bir yanýt olarak laparatomi uygulamaktadýrlar. Ancak laparatominin yeri yoktur. Spontan pneumoperitonium ve abdominal kompartman sendromu birlikteliði ise son derece nadirdir. Bu yazýda amacýmýz, spontan pnömoperitoneumun farkýndalýðýný artýrmak ve gereksiz laparatomilerin önlenmesine katkýda bulunmaktýr.

Bedside decompression of abdominal compartment syndrome caused by spontaneous pneumoperitoneum: A case report

Pneumoperitoneum is the presence of free air within the peritoneal cavity and indicates perforation of a hollow viscus. However, it may also occur in the absence of perforation and in this case, it is called spontaneous pneumoperitoneum (SP). A 57-year-old female patient who was intubated and mechanically ventilated due to respiratory failure developed abdominal compartment syndrome (ACS) secondary to massive SP. Peritoneal lavage was performed for the patient both to achieve decompression and to support the diagnosis. Many surgeons proceed with laparotomy as a reflex response for SP due to lack of awareness of the condition. However, laparotomy has no place in this setting. SP coexisting with ACS is extremely rare. With this case report, we aimed to raise awareness of SP among physicians and help avoid unnecessary laparotomies.