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Joao Kleber de Almeida Gentile
Faculdade de Medicina-Universidade Cidade de São Paulo (FM-UNICID), Brazil
Posters & Accepted Abstracts: J Hepato Gastroenterol
Statement of the problem: To understand the relationship between pneumothorax and the occurrence of pneumoperitoneum in a patiente with difficult airway. The use of mechanical ventilation can be performed in situations where patients need ventilatory support to maintain adequate oxygenation. Its inappropriate use can cause some complications, among them: pneumothorax and pneumoperitoneum. Our report describes a 28-year-old man admitted to the ICU with a diagnosis of Covid-19 requiring mechanical ventilation with orotracheal intubation due to acute respiratory failure. Methodology: Case report and literature review. Findings: The pathophysiological findings of COVID-19 infection is diffuse alveolar injury, a condition that results in an overall fragility of the lung parenchyma structure due to excessive inflammatory mediators and increased alveolar pressure. The patient under mechanical ventilation with moderate to high PEEP (positive end expiratory pressure) is exposed to a series of possible complications, which may have a simple resolution or even result in more severe repercussions, such as pneumothorax. Conclusion: the use of mechanical ventilation should be performed with caution, maintaining lung preservation, avoiding pneumothorax that can induce pneumoperitoneum. Finally, according to the evidence, it is believed that in this case report, pneumoperitoneum secondary to pneumothorax was caused by the use of mechanical ventilation associated with decreased lung compliance, resulting from de novo Coronavirus disease.
