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Hemodynamic Shock Caused by Tension Pneumoperitoneum in a 5-Year-Old Girl

Zentar, Marie-Sophie, MD*; Berteloot, Laureline, MD; Khen Dunlop, Naziha, MD, PhD‡§; Bustarret, Olivier, MD; Pigneur, Bénédicte, MD, PhD; Cheron, Gérard, MD; Angoulvant, François, MD, PhD*

doi: 10.1097/PEC.0000000000001471
Illustrative Cases

Tension pneumoperitoneum is a relatively rare occurrence in the pediatric population. However, tension pneumoperitoneum is associated with significant morbidity and mortality if it is not promptly diagnosed and treated. A 5-year-old girl was admitted to emergency department with abdominal pain. She was in shock, and the radiograph film of the abdomen revealed a voluminous tension pneumoperitoneum. Aggressive fluid challenges were performed in intensive care followed by urgent laparotomy. Primary abdominal compartment due to trapped gas caused a decreased venous return and visceral perfusion. In the absence of hemodynamic improvement after vascular filling, needle decompression was performed before surgery.

From the Departments of *Pediatric Emergency,

Radiology, and

Pediatric Surgery, Necker-Enfants Malades Hospital, Assistance Publique–Hôpitaux de Paris;

§University Paris Descartes; and Departments of

Anesthesiology and Pediatric Critical Care and

Pediatric Gastroenterology, Necker-Enfants Malades Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France.

Disclosure: The authors declare no conflict of interest.

Reprints: Marie-Sophie Zentar, MD, Service des Urgences Pédiatriques, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris Cedex 15, France (e-mail: marie-sophie.zentar@nck.aphp.fr).

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