Abstract:
Introduction. Pneumoperitoneum is defined as the presence of air in the
abdominal cavity. One of the non-surgical causes of
pneumoperitoneum is mechanical ventilation, with
sporadic cases caused by the pandemic period and the
management of COVID-19 patients.Purpose. Management of spontaneous pneumoperitoneum in
COVID-19 patient.Material and methods. Woman, 64 years old, hospitalized in serious condition in
ATI, COVID-19 confirmed, 4 days after the onset.
Progressive worsening tachypnea - 26-30 breaths per
minute, 84% SPO2-
, NIV intolerance. Difficult intubation.
Postintubation - sudden increase in volume of the
abdomen, disappearance of liver dullness, diffuse
eardrum. BP 75 / 47mmHg, HR 134bpm, SPO2 45%,
cardiotonics were administered. Results. The absence of the ulcer anamnesis and the favorable
circumstances establish the suspicion of non-surgical
pneumoperitoneum. Infraumbilical laparocentesis:
pressurized air was evacuated. BP 102/65 mmHg, HR at
74beats per minute, SO2 89-91%. No peritoneal signs
were detected. Drain extraction on the 3rd day. Death on
the 39th day after admission.Conclusions. The diagnosis of non-surgical pneumoperitoneum should
be considered in COVID-19 patients on oxygen support,
being a rare nosology, but with major repercussions in
case of poor management.