Management of non-surgical pneumoperitoneum

Abstract

Percutaneous endoscopic gastrostomy (PEG) is the best approach to feeding patients not eligible for oral nutrition who have a functioning digestive system. Pneumoperitoneum after PEG is a relatively common complication. As regards management, the most important decision is whether conservative therapy or an exploratory laparotomy should be indicated. We report the case of a patient with giant pneumoperitoneum following PEG, who was successfully managed with percutaneous air drainage.

Management of incidentally detected idiopathic pneumoperitoneum: A case report and literature review

“…Emergency surgery is needed to control the source of infection in patients with signs of peritoneal irritation or impaired general status, which imply sepsis arising from intraperitoneal infection [7] . By contrast, conservative management should be initially considered for asymptomatic patients who are hemodynamically stable without peritonitis [8] , [9] . A recent multicenter retrospective study revealed that operative treatment is associated with increased morbidity in patients without peritonitis [10] .…”