A Sneaky Case of Pneumoperitoneum

The enigma of asymptomatic idiopathic pneumoperitoneum: A dangerous trap for general surgeons

“…Finally, there exists a group of patients with pneumoperitoneum who have no clear aetiology or demonstrable risk factors; these are true cases of idiopathic pneumoperitoneum [ 2 ]. The majority of these cases present with a variety of symptoms including abdominal pain, distension, fever, and raised inflammatory markers, but without clinical signs of peritonitis [ 1 , 9 , 19 , 20 , 25 , 26 ]. Our patient is an exceedingly rare case of idiopathic pneumoperitoneum who was completely asymptomatic from the abdominal point of view.…”

“…If the patient does not exhibit signs of peritonitis, conservative management with close observation may suffice [ [28] , [29] , [30] ]. Treatment methods such as intravenous antibiotics, total parenteral nutrition, bowel rest, serial examinations, and repeat imaging have all been documented in the literature with success [ 5 , 25 , 26 ]. It must be noted that clinical deterioration always presents a potential indication for surgical intervention.…”