Case Report

Published: Dec 01, 2025 | DOI: 10.24911/ejmcr.9-2315

Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report


Authors: Pieter-Jan Moonen , Marc Vanhoof , Eva Boonen , Filiep Soetens ,


Article Info

Authors

Pieter-Jan Moonen

AZ Turnhout Department of Emergency Medicine

Marc Vanhoof

Department of Anesthesiology and Intensive Care Medicine, Turnhout, Belgium

Eva Boonen

Department of Anesthesiology and Intensive Care Medicine, Turnhout, Belgium

Filiep Soetens

Department of Emergency Medicine, Turnhout, Belgium

Publication History

Received: July 31, 2025

Accepted: October 13, 2025

Published: December 01, 2025


Abstract


Background: Complications from cardiopulmonary Resuscitation (CPR) are common and can add to morbidity and mortality. A pneumoperitoneum after CPR is an uncommon complication. The majority of previously reported cases of gastric perforation after CPR were associated with difficult airway management or positive pressure ventilation in association with chest compressions.


Case Presentation: We present a case of a massive pneumoperitoneum in a 53-year-old woman after resuscitation following attempted hanging. During and following basic and advanced life support, a massive swelling of the abdomen due to massive pneumoperitoneum was observed, most likely caused by gastric perforation after bag-valve mask ventilation on an obstructed airway. The pneumoperitoneum resolved after conservative measures and insertion of an intra-abdominal drain; no surgery was necessary. The patient made a good and full recovery.


Conclusion: This case emphasizes the importance of maintaining vigilance for gastric perforation with abdominal distention after CPR, in particular when difficult airway management is encountered. Prevention of gastric dilation and perforation can be achieved by diligent airway management and prevention of high inspiratory pressures. Conservative management using only an abdominal drain can be effective in selected cases when perforation is limited and in the absence of peritonitis.


Keywords: Resuscitation, Pneumoperitoneum, bag-valve mask ventilation, airway obstruction, prevention, conservative management


Pubmed Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens. Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report. EJMCR. 2025; 01 (December 2025): -. doi:10.24911/ejmcr.9-2315

Web Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens. Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report. https://ejmcr.com/articles/2315 [Access: December 19, 2025]. doi:10.24911/ejmcr.9-2315

AMA (American Medical Association) Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens. Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report. EJMCR. 2025; 01 (December 2025): -. doi:10.24911/ejmcr.9-2315

Vancouver/ICMJE Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens. Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report. EJMCR. (2025), [cited December 19, 2025]; 01 (December 2025): -. doi:10.24911/ejmcr.9-2315

Harvard Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens (2025) Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report. EJMCR, 01 (December 2025): -. doi:10.24911/ejmcr.9-2315

Chicago Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens. "Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report." 01 (2025), -. doi:10.24911/ejmcr.9-2315

MLA (The Modern Language Association) Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens. "Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report." 01.December 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2315

APA (American Psychological Association) Style

Pieter-Jan Moonen, Marc Vanhoof, Eva Boonen, Filiep Soetens (2025) Massive pneumoperitoneum after cardiopulmonary resuscitation: a case report. , 01 (December 2025), -. doi:10.24911/ejmcr.9-2315