Delayed Pneumoperitoneum and Acute Pulmonary Edema Secondary to Acute Gastric Dilatation

• Published in: Clinical endoscopy Vol. 48; no. 6; pp. 566 - 569
• Main Authors: Ahn, Jae Yun, Kim, Jong Kun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastrointestinal Endoscopy 01.11.2015; Korean Society of Gastrointestinal Endoscopy; 대한소화기내시경학회
• Subjects: Acute gastric dilatation; Acute pulmonary edema; Case Report; Pneumoperitoneum; 내과학; Pneumoperitoneum; Acute gastric dilatation; Acute pulmonary edema
• ISSN: 2234-2400; 2234-2443
• DOI: 10.5946/ce.2015.48.6.566

Pneumoperitoneum caused by acute gastric dilatation (AGD) is a very rare complication. We report a case of pneumoperitoneum and acute pulmonary edema caused by AGD in a patient with Parkinson's disease. A 78-year-old woman presented with pneumonia and AGD. We inserted a nasogastric tube and administered empirical antibiotics. We performed an endoscopy, and perforation or necrosis of the stomach and pyloric stenosis were not observed. Thirty-six hours after admission, the patient suddenly developed dyspnea and shock, and eventually died. We suspected the cause of death was pneumoperitoneum and acute pulmonary edema caused by AGD during the conservative treatment period. Immunocompromised patients with chronic illness require close observation even if they do not show any symptoms suggestive of complications. Even if the initial endoscopic or abdominal radiologic findings do not show gastric necrosis or perforation, follow-up with endoscopy is essential to recognize complications of AGD early.