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A Journal on Surgery

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Chirurgia 2003 August;16(4):151-4

language: English

Nonsurgical pneumoperitoneum. A case report and an algorithm for diagnosis and treatment

Vagni V., Mazzoni G., Iafrancesco M., Raparelli L., Iafrancesco D., Mazzarella Farao R.


Pneumoperitoneum is usually related to perforation of hollow viscus with associated peritonitis. Nonsurgical spontaneous peritoneum has been well documented in the literature. Previous study classified the sources of NSPP in: oropharyngeal, intrathoracic, intra-abdominal, and extra-abdominal. NSPP of obscure etiology were also identified. Although pathogenesis has been sufficiently clarified, an algorithm for diagnosis and treatment is lacking. The authors describe a case of spontaneous nonsurgical pneumoperitoneum and review the literature. Because negative laparotomies could be decreased by recognizing this kind of disease the authors propose an algorithm for diagnosis and treatment. The rules to be respected for performing diagnostic examinations correctly are underlined. When a nonsurgical cause of pneumoperitoneum can be discerned and clinical examination can be performed for 24-48 hours, in the absence of signs of peritonitis, an unnecessary laparotomy had to be avoided.

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