{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:25:05Z","timestamp":1780334705598,"version":"3.54.1"},"reference-count":12,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Pneumoperitoneum is the presence of air within the peritoneal cavity and is mostly caused by organ rupture. Spontaneous pneumoperitoneum accounts 5% to 15% of the cases and occurs in the absence of organ damage. The pulmonary origin of pneumoperitoneum is unusual, and probably associated with mechanical ventilation and alveolar leak. In patients with coronavirus disease 2019 (COVID-19) there are some reports of air leak, like pneumothorax, pneumomediastinum, pneumoperitoneum, and subcutaneous emphysema.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>We present the case of a 70-year-old man with COVID-19 pneumonia admitted to the Intensive Care Unit (ICU). Since admission he was on Non-Invasive Ventilation (NIV), without improvement, needing Invasive Mechanical Ventilation (IMV) due to severe respiratory failure. Five days after IMV despite protective lung ventilation, massive spontaneous subcutaneous emphysema, pneumomediastinum and pneumoperitoneum were diagnosed. Besides initial conservative management 12 hours later, the patient developed abdominal compartment syndrome requiring percutaneous needle decompression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Pneumoperitoneum can be considered a rare complication of COVID-19 pneumonia and its management, resulting not only from the viral pulmonary but also from secondary causes. Conservative management should be usually enough. However, in the presence of abdominal compartment syndrome prompt recognition and treatment are crucial and eventually lifesaving.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2478\/jccm-2023-0018","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T09:53:36Z","timestamp":1691661216000},"page":"192-197","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19: A Possible Cause of Spontaneous Pneumoperitoneum"],"prefix":"10.2478","volume":"9","author":[{"given":"Patr\u00edcia Varela","family":"Ramos","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Hospital de Vila Franca de Xira , Vila Franca de Xira , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital de Vila Franca de Xira , Vila Franca de Xira , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c2ngela","family":"Simas","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital de Vila Franca de Xira , Vila Franca de Xira , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida","family":"Rocha Vera Cruz","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital de Vila Franca de Xira , Vila Franca de Xira , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,7,31]]},"reference":[{"key":"2024042711185640149_j_jccm-2023-0018_ref_001","doi-asserted-by":"crossref","unstructured":"Duarte R, Duarte E, Ochoa J, Leiva M, Pimentel-Hayashi J. Pneumoperitoneum in a COVID-19 Patient Due to the Macklin Effect. Cureus. 2021. 13(2):e13200. doi:10.7759\/cureus.13200.","DOI":"10.7759\/cureus.13200"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_002","doi-asserted-by":"crossref","unstructured":"Utomo S, Notopuro F, Rosalina S. Massive emphysema subcutis, pneumothorax, pneumomediastinum and pneumoperitoneum as uncommon complication of covid-19 pneumonia, a rare case. Radiol Case Rep. 2021. 16(8):2133\u20132138.","DOI":"10.1016\/j.radcr.2021.05.002"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_003","doi-asserted-by":"crossref","unstructured":"Somasundraw K, Agbontaen K, Singh S. Pneumomediastinum in COVID-19: Merely a Matter of Lung Frailty? Respiration. 2021. 1251\u20131255.","DOI":"10.1159\/000518367"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_004","doi-asserted-by":"crossref","unstructured":"Nasa P, Juneja D, Jain R. Air leak with COVID-19 \u2013 A meta-summary; Asian Cardiovasc Thorac Ann. 2022. 30(2):237\u2013244.","DOI":"10.1177\/02184923211031134"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_005","doi-asserted-by":"crossref","unstructured":"Matsuura H, Okita A. Tension Pneumoperitoneum Attributable to COVID-19. Am J Trop Med Hyg. 2021.105(2):271\u2013272. DOI: 10.4269\/ajtmh.21-0254.","DOI":"10.4269\/ajtmh.21-0254"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_006","unstructured":"Belletti A, Palumbo D, Zangrillo A, et al. Predictors of pneumothorax\/pneumomediastinum in mechanically ventilated COVID-19 patients. J Cardiothorac Vasc Anesth. 2021. Feb 6:S1053\u20130770 (21)."},{"key":"2024042711185640149_j_jccm-2023-0018_ref_007","doi-asserted-by":"crossref","unstructured":"Ozsoy I, Tezcan M, Guzeldag S, Ozdemir A. Is spontaneous pneumomediastinum a poor prognostic factor in Covid-19? J Coll Physicians Surg Pak. 2021. 31:132\u2013137.","DOI":"10.29271\/jcpsp.2021.02.132"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_008","doi-asserted-by":"crossref","unstructured":"Morataya C, Armin S, Nugent K. Ventilator management using esophageal balloon pressure measurements. The Southwest Respiratory and Critical Care Chronicles. 2022. 10(43), 18\u201325.","DOI":"10.12746\/swrccc.v10i43.1037"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_009","doi-asserted-by":"crossref","unstructured":"Damous S, Junior J, Pezzano A, et. al. Pneumomediastinum complicating COVID-19: a case series. Eur J Med Res. 2021. 26:114.","DOI":"10.1186\/s40001-021-00585-9"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_010","doi-asserted-by":"crossref","unstructured":"Mohan V, Tauseen RA. Spontaneous pneumomediastinum in COVID-19. BMJ Case Rep. 2020. 13:e236519. DOI:10.1136\/bcr-2020-236519.","DOI":"10.1136\/bcr-2020-236519"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_011","doi-asserted-by":"crossref","unstructured":"Lemmers D, Hilal M, Bn\u00e1 C, et al. Pneumomediastinum and subcutaneous emphysema in COVID-19: barotrauma or lung frailty? ERJ Open Res.2020 Nov 16;6(4):00385-2020. DOI: 10.1183\/23120541.00385-2020.","DOI":"10.1183\/23120541.00385-2020"},{"key":"2024042711185640149_j_jccm-2023-0018_ref_012","doi-asserted-by":"crossref","unstructured":"Papazian L, Aubron C, Brochard L. et al. Formal guidelines: management of acute respiratory distress syndrome. Ann. Intensive Care 9, 69 (2019).","DOI":"10.1186\/s13613-019-0540-9"}],"container-title":["The Journal of Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.sciendo.com\/pdf\/10.2478\/jccm-2023-0018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T11:19:08Z","timestamp":1714216748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.sciendo.com\/article\/10.2478\/jccm-2023-0018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,7,31]]},"published-print":{"date-parts":[[2023,7,1]]}},"alternative-id":["10.2478\/jccm-2023-0018"],"URL":"https:\/\/doi.org\/10.2478\/jccm-2023-0018","relation":{},"ISSN":["2393-1817"],"issn-type":[{"value":"2393-1817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,1]]}}}