Department of Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Burn injury, especially severe facial burn injury, poses a unique challenge for emergency health care personnel in administering cardiopulmonary resuscitation. Because of the perioral and oral edema with severe facial burns, intubation may be difficult, and bag-valve mask or mouth-to-mouth resuscitation may be prolonged. As a result of the difficulty in establishing a patent airway, various complications can arise. One of these includes gastric perforation which, although rare in the setting of difficult intubation or prolonged oral ventilation, may be possible. To our knowledge, acute gastric perforation after prolonged cardiopulmonary resuscitation in burn injured patients has not previously been reported thus the incidence is unknown. We report here a case of gastric perforation after a difficult tracheal intubation in a patient with extensive burns of the head and neck and 63% TBSA burn.