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Case Reports

Cardiac Arrest Caused by Tension Pneumomediastinum in a Boerhaave Syndrome Patient

^a Department of Surgery and Surgical Nursing, Medical University, St. John Hospital, Lublin, Poland
^b Department of Anaesthesiology and Intensive Care, St. John Hospital, Lublin, Poland
^c Department of Radiology, St. John Hospital, Lublin, Poland

Accepted for publication August 6, 2008.

^_* Address correspondence to Dr Paluszkiewicz, Department of Surgery and Surgical Nursing, Medical University, 6 Chodzki St, Lublin, PL-20950, Poland (Email: ppalusz{at}uhc.com.pl).

This report presents a 23-year-old man with esophageal perforation, tension pneumomediastinum, and subsequent cardiorespiratory arrest. Initial resuscitation by cervical and subxiphoid mediastinotomy was ineffective. Bedside decompression of the posterior mediastinum through the esophageal hiatus of the diaphragm resulted in immediate return of a normal sinus rhythm and noncompromised mechanical ventilation. The patient made a full recovery and was discharged on day 12. Transhiatal decompression of the posterior mediastinum can be recommended for the treatment of cardiorespiratory complications in patients with tension pneumomediastinum in whom the classic cervical and subxiphoid mediastinotomies are ineffective.

This article has been cited by other articles:

				M. Keane, T. Gowripalann, A. Brodbeck, and P. Bothma A lesson in clinical findings, diagnosis, reassessment and outcome: Boerhaave's syndrome BMJ Case Reports, June 21, 2012; 2012(jun21_1): bcr2012006485 - bcr2012006485. [Abstract] [Full Text] [PDF]