# A Case Report of Pneumoretroperitoneum from Blunt Trauma in a Patient with Chronic Obstructive Pulmonary Disease

## TL;DR

A patient with chronic lung disease experienced a rare condition where air entered the abdominal cavity after a fall-related injury.

## Contribution

This case report highlights pneumoretroperitoneum in a COPD patient following blunt trauma.

## Key findings

- Pneumoretroperitoneum occurred after a cardiac arrest during a COPD exacerbation.
- Blunt trauma combined with lung disease can lead to rare and severe complications.
- The Macklin effect may explain the pathophysiology of air spread in such cases.

## Abstract

Pneumomediastinum is a rare complication of blunt traumatic injury and is thought to be due to the Macklin effect, a pathophysiologic process comprised of three steps: alveolar rupture secondary to blunt injury; air dissecting along bronchovascular sheaths; and spread of pulmonary interstitial edema into the mediastinal space. Pneumomediastinum is rarely associated with pneumoretroperitoneum.

We present a case of a patient who suffered a cardiac arrest after a fall during a chronic obstructive pulmonary disease exacerbation, leading to pneumoretroperitoneum.

This case highlights the complications that can arise from blunt trauma and how underlying lung pathology can worsen these complications.