Spontaneous tension pneumoperitoneum presenting as an out of hospital cardiac arrest: A case report and review of the literature.

OBJECTIVES: It is known that tension pneumoperitoneum (TPP) can lead to cardiopulmonary arrest but it does not figure in the advanced life support algorithms. Therefore we discuss a case of TPP together with the literature review of its aetiology and treatment. PATIENT: We describe an out of hospital cardiac arrest due to a spontaneous TPP secondary to a perforated duodenal ulcer. CONCLUSION: Emergency personnel should consider the possibility of TPP in a patient with a distended abdomen and a cardiac arrest, even in the absence of known traumatic and iatrogenic causes for TPP. We believe that TPP should be added as a reversible cause for pulseless electrical activity in the resuscitation guidelines.