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,
‡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: email@example.com).