Vidrio Duarte Ramon, Vidrio Duarte Eduardo, Gutierrez Ochoa Juan, Gaviria Leiva Maria Camila, Pimentel-Hayashi Joaquin A
General Surgery, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, MEX.
General Surgery, Hospital Angeles Metropolitano, Mexico City, MEX.
Cureus. 2021 Feb 7;13(2):e13200. doi: 10.7759/cureus.13200.
A 63-year-old male with coronavirus disease 2019 (COVID-19) pneumonia presented to the emergency department, supplementary oxygen is delivered via nasal cannula, and invasive ventilation was not needed; there was significant pneumoperitoneum on radiologic control. After a meticulous examination of the thoracic tomography, there were some linear air collections adjacent to the bronchovascular sheaths, indicative of the Macklin effect, without abdominal alterations, and the patient remained stable; therefore, we did not perform a surgical procedure, and the pneumoperitoneum reabsorbed spontaneously on radiologic control. The pulmonary origin of pneumoperitoneum is unusual and is associated with mechanical ventilation and alveolar leak; the air leak with subsequent dissection into other anatomical spaces is called the Macklin effect. It is essential to have this mechanism in mind because most of these patients respond well to conservative treatment. When studying primary pneumoperitoneum, the cause should be studied carefully to discard visceral perforation, tracheal or esophageal rupture.
一名患有2019冠状病毒病（COVID-19）肺炎的63岁男性被送往急诊科，通过鼻导管给予补充氧气，无需有创通气；影像学检查显示有明显的气腹。在对胸部断层扫描进行细致检查后，支气管血管鞘周围有一些线状气体聚集，提示存在麦金效应，腹部无改变，患者病情保持稳定；因此，我们未进行外科手术，气腹在影像学检查时自行吸收。气腹源于肺部的情况并不常见，与机械通气和肺泡渗漏有关；气体泄漏并随后扩散到其他解剖空间被称为麦金效应。必须牢记这一机制，因为这些患者中的大多数对保守治疗反应良好。在研究原发性气腹时，应仔细研究病因以排除内脏穿孔、气管或食管破裂。
