Gastric rupture with tension pneumoperitoneum: a complication of difficult endotracheal intubation

Ann Emerg Med. 1997 Sep;30(3):343-6. doi: 10.1016/s0196-0644(97)70173-2.


Gastric rupture is a rare complication of difficult airway management. In cases of vigorous mouth-to-mouth ventilation, bag-valve-mask ventilation, or esophageal intubation, gastric rupture and massive intraperitoneal free air may cause tension pneumoperitoneum. Hemodynamic instability necessitates immediate intervention, including needle decompression of the peritoneum followed by surgical exploration. We recently encountered two cases of gastric rupture with tension pneumoperitoneum that occurred after difficult endotracheal intubation. This report describes the presentation, treatment, and prevention of this entity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Emergencies
  • Fatal Outcome
  • Female
  • Humans
  • Intubation, Intratracheal / adverse effects*
  • Middle Aged
  • Pneumoperitoneum / complications
  • Pneumoperitoneum / etiology*
  • Rupture, Spontaneous
  • Stomach Diseases / complications
  • Stomach Diseases / etiology*