중증 천식 환아에서 기계환기 후 발생한 기복 1례
A Case of Pneumoperitoneum After Mechanical Ventilation inA Child with Severe Bronchial Asthma
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기계적 환기 후에 발생하는 기복은 폐 용적 상해나 압력 상해의 흔하지 않은 증상이지만 복강내 장기 천공에 의한 기복과의 감별이 필수적이다. 전형적인 복막염 증상 및 징후가 없고 비외과성 기복일 가능성이 있는 병력이 있을 때 좀 더 정확한 진단방법을 통하여 비외과성 기복임을 입증하고 이 경우 관찰 및 보존적 요법으로 치료하여 불필요한 개복수술을 피해야 할 것이다. 저자들은 폐렴을 동반한 중증 기관지 천식 환아에서 기계환기 후 발생한 기복 및 음낭기종 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Massive pneumopritoneum developing immediately following initiation of artificial ventilation is an unusual sign of lung barotrauma and must be distinguished from pneumoperitoneum following rupture of a hollow abdominal viscus. Besides, pneumoperitoneum occurring in a mechanically ventilated asthmatic patient can present a diagnostic dilemma as the usual signs of an intestinal perforation may be masked by steroid therapy, sedation or paralysis, or combination of all three. We report a case of massive pneumoperitoneum after initiation of mechanical ventilation in a child with severe asthmatic attack.
참고문헌 (16)
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