Spontaneous idiopathic recurrent pneumoperitoneum

Abstract

Pneumoperitoneum, gas under the diaphragm, is often a sign of significant intra-abdominal pathology, be it perforation in the stomach or duodenum secondary to peptic ulcer disease or in the small or large bowel as a result of inflammatory bowel diseases, diverticulitis or cancer, it can also be iatrogenic as a result of endoscopy or laparoscopy. The diagnosis is made with erect chest and abdominal radiographs, air is usually most visible under the right hemi-diaphragm. Here, we present a troublesome case of recurrent pneumoperitoneum, which despite extensive investigations and laparotomy no cause was found.

The clinical dilemma of the persistent idiopathic pneumoperitoneum: A case report

“…What is unique is our case is the persistence of pneumperitoneum over a period of months in a clinically-well and asymptomatic patient. Only a handful of cases of in the literature described a recurrent pattern of IP, but in these cases, all underwent negative exploratory laparotomies, while ours was successfully managed conservatively [3,5,13]. To our knowledge, our case is the first in the literature of an idiopathic pneumoperitoneum that persisted on subsequent radiology and was managed successfully without surgical intervention.…”

Recurrent Idiopathic Spontaneous Pneumoperitoneum: A Case Report

“…ISP is a rare condition with only a few case reports [1][2][3]. There have been no well-defined risk factors, and only a few cases of recurrence have been noted [1]. Presentation is variable and nonspecific.…”

Un cas rare de pneumopéritoine spontané massif: à propos d’une observation

“…L’insufflation au cours des explorations digestives endoscopique, peut aussi être incriminée comme cause iatrogène [ 3 ]. Devant un pneumopéritoine avec douleur abdominale les investigations cliniques, biologiques et l’imagerie s’orientent automatiquement vers une urgence chirurgicale abdominale et doivent rechercher en premier une perforation du tractus digestif, les étiologies les plus fréquemment rencontrées sont représentées par: la péritonite par perforation d’ulcère, une complication de MICI (maladie inflammatoire chronique de l’intestin), la diverticulose colique ou le cancer [ 3 , 4 ]. La tomodensitométrie constitue l’imagerie de choix et peut orienter vers une étiologie abdominale évidente du pneumopéritoine [ 4 - 6 ] .…”