Tension pneumoperitoneum
Updates to Article Attributes
Tension pneumoperitoneum is a special and rare type of pneumoperitoneum, in which the free intra-abdominal peritoneal gas is under pressure.
Pathology
The mechanism is thought to be a ball-valve effect allowing the one-way accumulation of gas. This results in:
elevation and splinting of the diaphragm reducing lung volumes
compression of intra-abdominal venous structures, e.g. inferior vena cava, resulting in reduced venous return and decreased cardiac output
Aetiology
Causes are essentially the same as those of a 'normal' pneumoperitoneum with iatrogenic causes e.g. mechanical ventilation, being over-represented.
Radiographic features
The radiographic features are the same as a routine pneumoperitoneum except that gas volumes are vast and abdominal distension is present.
Treatment and prognosis
Just as in tension pneumothorax, prompt surgical intervention is required to prevent death.
-<li>elevation and splinting of the diaphragm reducing lung volumes</li>-<li>compression of intra-abdominal venous structures, e.g. <a href="/articles/inferior-vena-cava-1">inferior vena cava</a>, resulting in reduced venous return and decreased cardiac output</li>-</ul><h5>Aetiology</h5><p>Causes are essentially the same as those of a 'normal' <a href="/articles/pneumoperitoneum">pneumoperitoneum</a> with iatrogenic causes e.g. mechanical ventilation, being over-represented.</p><h4>Radiographic features</h4><p>The radiographic features are the same as a routine <a href="/articles/pneumoperitoneum">pneumoperitoneum</a> except that gas volumes are vast and abdominal distension is present.</p><h4>Treatment and prognosis</h4><p>Just as in <a href="/articles/tension-pneumothorax">tension pneumothorax</a>, prompt intervention is required to prevent death. </p>- +<li><p>elevation and splinting of the diaphragm reducing lung volumes</p></li>
- +<li><p>compression of intra-abdominal venous structures, e.g. <a href="/articles/inferior-vena-cava-1">inferior vena cava</a>, resulting in reduced venous return and decreased cardiac output</p></li>
- +</ul><h5>Aetiology</h5><p>Causes are essentially the same as those of a 'normal' <a href="/articles/pneumoperitoneum">pneumoperitoneum</a> with iatrogenic causes e.g. mechanical ventilation, being over-represented.</p><h4>Radiographic features</h4><p>The radiographic features are the same as a routine <a href="/articles/pneumoperitoneum">pneumoperitoneum</a> except that gas volumes are vast and abdominal distension is present.</p><h4>Treatment and prognosis</h4><p>Just as in <a href="/articles/tension-pneumothorax">tension pneumothorax</a>, prompt surgical intervention is required to prevent death. </p>
Image 5 X-ray (Frontal) ( create )
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