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Kardiyopulmoner resüsitasyon sonrası gelişen pnömoperitoneum

Pneumoperitoneum developing after cardiopulmonary resuscitation

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Abstract (2. Language): 
Pneumoperitoneum developing after cardiopulmonary resuscitation may result either from visceral organ perforation or passage of mediastinal air via the diafragmatic hiatus of esophageus and aorta or directly through pleural and diafragmatic defects. A 77-year-old female patient was transferred to intensive care unit due to respiratory failure developing after coronary bypass surgery. Massive subcutaneous emphysema developed after tracheostomy. Tracheostomy cannula, therefore, was removed, and the patient was reintubated. Later acute cardiac arrest developed, and cardiopulmonary resuscitation was performed. Free air was detected below both diaphragms on chest radiograph. Conservative treatment was performed in the patient without peritoneal irritation signs or abdominal free fluid. Subdiaphragmatic free air completely disappeared after four days.
Abstract (Original Language): 
Kardiyopulmoner resüsitasyon sonrası gelişen pnömoperitoneum visseral organ perforasyonu ya da mediyastinal havanın özefagus ve aortun diyafragmatik geçiş yerleri veya plevral ve diyafragmatik defektlerden direkt ge- çişi sonucu oluşmaktadır. Yetmiş yedi yaşında kadın hasta koroner baypas ameliyatı sonrasında solunum yetmezliği nedeniyle yoğun bakım ünitesine alındı. Trakeostomi açıldıktan sonra hastada yaygın cilt altı amfizemi gelişti. Bunun üzerine hastanın trakeostomi kanülü çekilerek tekrar entübe edildi. Daha sonra hastada ani kardiyak arrest gelişti ve kardiyopulmoner resüsitasyon uygulandı. Göğüs grafisinde her iki diyafragma altında serbest hava saptandı. Peritoneal irritasyon bulguları olmayan ve abdomende serbest mayi saptanmayan hastaya konservatif tedavi uygulandı. Dört gün sonra ise diyafragma altındaki havanın tamamen rezorbe olduğu gözlendi.
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REFERENCES

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