Approach to Pneumoperitoneum After Cardiopulmonary Resuscitation

Intestinal anastomosis blowout following post-operative cardiopulmonary resuscitation: A case report

“…Abdominal distention following CPR not relieved by an NG tube is highly suggestive of a pneumoperitoneum caused by esophageal or gastric perforation [18] . When available, esophagogastroduodenoscopy (EGD) and bronchoscopy should both be done in patients who have pneumoperitoneum after CPR, in order to diagnose esophageal, gastric, duodenal, or tracheobronchial injuries [19] . If the patient remains in a stable clinical condition without signs of peritonitis and imaging studies are negative, a non-operative approach can be pursued [16,19,20] .…”

“…When available, esophagogastroduodenoscopy (EGD) and bronchoscopy should both be done in patients who have pneumoperitoneum after CPR, in order to diagnose esophageal, gastric, duodenal, or tracheobronchial injuries [19] . If the patient remains in a stable clinical condition without signs of peritonitis and imaging studies are negative, a non-operative approach can be pursued [16,19,20] . However, the patient should be closely followed, with serial physical examination and repeat complete blood counts to evaluate for developing peritonitis [16,19] .…”

“…If the patient remains in a stable clinical condition without signs of peritonitis and imaging studies are negative, a non-operative approach can be pursued [16,19,20] . However, the patient should be closely followed, with serial physical examination and repeat complete blood counts to evaluate for developing peritonitis [16,19] . Diagnostic peritoneal lavage (DPL) may be a reasonable alternative to surgical exploration in patients without signs of peritonitis and where investigative capabilities such as EGD or CT scan are not available [19] .…”

Stomach perforation post cardiopulmonary resuscitation—A case report

“…A non-operative conservative management is described in literature [6] , [19] , [20] , [21] . Some authors argue that laparotomy is not necessary if the patient’s abdomen has no signs of peritonitis or if peritoneal lavage and gastric studies are negative [3] , [4] , [5] , [21] . Peritoneal lavage may be a reasonable alternative to surgical exploration in a patient without signs of peritonitis but negative results do not rule out the diagnosis.…”

Unexplained Massive Pneumoperitoneum following Cardiopulmonary Resuscitation

“…In stable patients, laparotomy should be considered if there were signs of peritonitis, the results of esophagogastroduodenoscopy (EGD) were not conclusive and perforation could not be ruled out. 9…”