Table 1 The proposed new classification of tension pneumoperitoneum
Primary tension pneumoperitoneum | Secondary tension pneumoperitoneum | |
|---|---|---|
Free gas originates below the diaphragm, within the peritoneal cavity. | Free gas originates above the diaphragm, outside the peritoneal cavity: mediastinum, lungs, and pleural spaces. | |
Perforation TP | Non-perforation TP | Esophageal and respiratory perforations |
Iatrogenic (endoscopy and CPR) | Anaerobic gas production (anaerobic bacterial peritonitis) | Iatrogenic (EGD, bronchoscopy and orotracheal intubation) |
Disease | Barotrauma (mechanical ventilation and blast injuries) | |
Blunt abdominal trauma and barotrauma (blast injuries) | Blunt chest trauma | |
Surgery | Surgery | |