Iatrogenic Pneumoperitoneum Following Peritoneal Dialysis in A Neonate with Methylmalonic Acidemia: A Rare Case Report

Muhammad Bin  Hammad; Fatima Tariq  Butt; Adnan  Mirza; Ibrahim  Mirza

doi:10.36283/ziun-pjmd14-3/084

Authors

Muhammad Bin Hammad Aga Khan University, Karachi, Pakistan
Fatima Tariq Butt Aga Khan University, Karachi, Pakistan
Adnan Mirza Aga Khan University, Karachi, Pakistan.
Ibrahim Mirza Baqai Medical University, Karachi, Pakistan.

DOI:

https://doi.org/10.36283/ziun-pjmd14-3/084

Keywords:

Methylmalonic acidemia, peritoneal dialysis, Pneumoperitoneum

Abstract

This is a case of a neonate who was brought to the hospital at 46 hours of life with symptoms of fatigue, difficulty breathing and hypoglycemia for the past 6 hours. His septic workup was normal; however, labs were consistent with high anion gap metabolic acidosis, hyperammonemia, and urine positive for methylmalonic acid. Due to persistent encephalopathy and high ammonia levels, he was intubated, and peritoneal dialysis (PD) was started. On day 3 of PD drain placement, the baby developed abdominal distension. Abdominal x-ray showed a football sign indicative of pneumoperitoneum. Tube feeding was started with special formula milk. The neonate improved clinically and was discharged at the 11^th day of life.

Author Biographies

Muhammad Bin Hammad, Aga Khan University, Karachi, Pakistan

Department of Pediatrics,
Fatima Tariq Butt, Aga Khan University, Karachi, Pakistan

Resident, Department of Pediatrics,
Adnan Mirza, Aga Khan University, Karachi, Pakistan.

Associate Professor, Department of Pediatrics
Ibrahim Mirza, Baqai Medical University, Karachi, Pakistan.

Medical Student,

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