An Intriguing Case of Pneumoperitoneum In a Patient With COVID-19: Do All Pneumoperitoneum Cases Need Surgery?

The COVID-19 pandemic involved the globe and resulted in major mortalities mainly affecting the respiratory system. Initially thought to be respiratory disease it was later postulated and confirmed the involvement of gastro-intestinal tract (GIT) and its contribution to the complications and mortalities. Herein we present five cases of severe COVID-19 infection with GI involvement and their management.

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“…Patients' details are given below in Table 1 [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] .…”

Section: Resultsmentioning

confidence: 99%

Acute Abdomen in the ERA of COVID 19: Case Series and Literature Review

Al-Qahtani

Al-Kuwari²,

Sameer³

et al. 2022

ijirms

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“…In cases where pneumoperitoneum is nonsurgical or idiopathic, there has been unnecessary explorative laparotomies, typically causing more harm than benefits [ 1 , 5 ]. The current literature suggests if a patient does not have any peritoneal symptoms and if imaging examinations show absence of abdominal cavity pathology, then, clinicians may consider spontaneous pneumoperitoneum, which does not require surgical intervention [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 90% of pneumoperitoneum cases require emergency surgical interventions because of the perforation of the hollow viscus. However, the remaining 10% can be self-limiting, and managed conservatively if there are none existential abdominal viscus perforation or any associations with the alimentary tract perforations [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Idiopathic pneumoperitoneum in a single case: an unusual entity

Sodade

Austin

Draper

2023

Journal of Surgical Case Reports

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Idiopathic pneumoperitoneum (IP) cases are rare and presents with varying symptoms, which makes propositions of standard treatments, clinically impracticable. There are limited IP therapies in the literature, necessitating a need, to continually highlight unique cases for the purpose of clinical education and training. This case describes an IP and management of a 34-year-old male who recently underwent a laparoscopic cholecystectomy. Patient presented to the emergency room with recurrent gastrointestinal (GI) symptoms. Despite two negative exploratory laparotomies without confirmatory evidence of GI perforations, the GI symptoms persisted, making it an unusual case. The surgeons elected to a multispecialty approach, detailing patient-specific symptoms, and corresponding treatments of the case. Based on the successful outcome of this patient, detailed knowledge of medical history, repeated physical assessments and patient-specific and comprehensive approach was shown to reduce unnecessary exploratory laparotomy, improved clinical outcomes and decrease in complications.

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“…This can make it extra challenging to differentiate between gastro-intestinal perforation, and pneumoperitoneum from other causes, e.g. alveolar barotrauma (the Macklin effect) ( 33 , 34 ). Similar to perforation in non-COVID patients, rapid diagnosis and surgical treatment is of the utmost importance, and can lead to favorable outcomes.…”

Section: Discussionmentioning

confidence: 99%