Gastric rupture with pneumoperitoneum after mouth-to-nose breathing in an infant.

Background: Gastric rupture with resulting tension pneumoperitoneum occurs rarely in infants. It may be associated with resuscitative efforts.

Objectives: This report presents a unique case of gastric rupture and illustrates the factors necessary for prompt recognition and treatment.

Case Report: The patient was a 16-week-old infant with nasal congestion whose father had attempted to clear her nose by a mouth-to-mouth-and-nose maneuver. The alert and attentive patient presented to the Emergency Department in respiratory distress, with marked abdominal distention. She was diagnosed with a massive tension pneumoperitoneum, which was decompressed by needle aspiration. A laceration of the lesser curvature of the stomach was repaired at laparotomy; the patient recovered uneventfully.

Conclusion: Tension pneumoperitoneum is rarely seen but has key defining elements. A simple procedure is critical to relief of the condition.