Non-surgical pneumoperitoneum after oro-genital intercourse

Cawich, Shamir O; Johnson, Peter; Williams, Eric H.; Naraynsingh, Vijay

doi:10.1016/j.ijscr.2013.08.022

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Moreover, a previous history of gynaecological surgery also was reported to be a risk factor for the development of spontaneous pneumoperitoneum. A distinct subset of patients who had undergone hysterectomy constituted a minority portion of instances involving pneumoperitoneum where no intraabdominal pathology was evident [7].…”

Section: Discussionmentioning

confidence: 99%

Pneumoperitoneum in a Patient with Endometriosis and Bilateral Salpingectomy after Sexual Activity

Kaddoura,

Abdalbari,

Ayach

et al. 2023

Arch Obstet Gynecol

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Pneumoperitoneum commonly occurs due to perforated viscus, yet a minority of cases can occur due to gynaecological causes, particularly following sexual activities. While not yet established, various hypotheses have been posited to explain the development of a spontaneous pneumoperitoneum after sexual intercourse. We herein present a unique case of a woman with a history of endometriosis and bilateral salpingectomy who presented with sudden abdominal pain that started after sexual activity. Subsequently, an emergent diagnostic laparoscopy was deemed necessary yielding no signs of perforation. However, an endometrial island was identified on the stump of the previous right salpingectomy during the procedure. Finally, the most likely cause of the patient’s spontaneous pneumoperitoneum was determined to be secondary to sexual activity and subsequent air transmission through an opening caused by her endometriosis. In conclusion, this report will showcase the importance of considering gynaecological pathologies as potential causes of spontaneous pneumoperitoneum, particularly following sexual activity. We intend to diminish the stigma associated with using sexual history as a diagnostic tool when faced with ambiguous cases of abdominal pain presentations.

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Section: Discussionmentioning

confidence: 99%

Pneumoperitoneum in a Patient with Endometriosis and Bilateral Salpingectomy after Sexual Activity

Kaddoura,

Abdalbari,

Ayach

et al. 2023

Arch Obstet Gynecol

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“…There have only been 19 reported cases of gynaecologically associated SP in the literature up to the year 2013 [6], with three of these cases being directly related to a recent hysterectomy or gynaecological surgery [7,8,9]. Jacobs et al [3] highlighted the potential mechanisms by which gas can enter the peritoneal cavity following either sexual activity or after a hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

A case report of spontaneous pneumoperitoneum after sexual intercourse following a total laparoscopic hysterectomy, bilateral saplingo-oophorectomy and infra-colic omentectomy

Anstis

Eskandar

2016

Gynecol Surg

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The finding of pneumoperitoneum on a chest radiograph is most commonly associated with an underlying viscus perforation (Mularski et al. West J Med 170:41-46, 1999). Urgent surgical intervention, in particular emergency laparotomy, is often required in these cases. However, in 10 % of patients, a perforated viscus is not the precipitating cause of a pneumoperitoneum (referred to as a spontaneous or nonsurgical pneumoperitoneum (SP). These cases are rarely associated with peritonitis and are usually managed conservatively (Mularski et al. West J Med 170:41-46, 1999; Pitiakoudis et al. J Med Case Rep 5:86, 2011). We present a case of a 28-yearold female presented to the Accident and Emergency department with a 6-h history of severe abdominal pain and bilateral shoulder tip pain. She reported that the pain developed 2 h following sexual intercourse. She had undergone a laparoscopic total hysterectomy, bilateral saplingo-oophorectomy and infra-colic omentectomy for borderline ovarian tumours 25 days previ-ously. The most likely cause of this patient's acute abdominal pain was a spontaneous pneumoperitoneum secondary to sexual activity. Clinicians should be aware with the potential non-surgical causes for the presence of a pneumoperitoneum, particularly in patients who are not presenting with the other characteristic clinical features of an acute gastrointestinal perforation such as peritonitis, fever and elevated white cell count. These particular patients can be largely managed conservatively.

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“…Rupture of subserosal gas bubbles in pneumatosis cystoides intestinalis is an example of this. Other routes of air penetration into the peritoneum are phrenic defects, perivascular sheaths along mediastinal vessels and the female genital tract [83][84][85][86][87]. The most common cause of pneumoperitoneum without perforation is abdominal surgery [84].…”

Section: Pitfalls and Differential Diagnosesmentioning

confidence: 99%

Gastrointestinal Ultrasound (GIUS) in Intestinal Emergencies – An EFSUMB Position Paper

et al. 2020

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An interdisciplinary group of European experts summarizes the value of gastrointestinal ultrasound (GIUS) in the management of three time-critical causes of acute abdomen: bowel obstruction, gastrointestinal perforation and acute ischemic bowel disease. Based on an extensive literature review, statements for a targeted diagnostic strategy in these intestinal emergencies are presented. GIUS is best established in case of small bowel obstruction. Metanalyses and prospective studies showed a sensitivity and specificity comparable to that of computed tomography (CT) and superior to plain X-ray. GIUS may save time and radiation exposure and has the advantage of displaying bowel function directly. Gastrointestinal perforation is more challenging for less experienced investigators. Although GIUS in experienced hands has a relatively high sensitivity to establish a correct diagnosis, CT is the most sensitive method in this situation. The spectrum of intestinal ischemia ranges from self-limited ischemic colitis to fatal intestinal infarction. In acute arterial mesenteric ischemia, GIUS may provide information, but prompt CT angiography is the gold standard. On the other end of the spectrum, ischemic colitis shows typical ultrasound features that allow correct diagnosis. GIUS here has a diagnostic performance similar to CT and helps to differentiate mild from severe ischemic colitis.

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Non-surgical pneumoperitoneum after oro-genital intercourse

Cited by 7 publications

References 20 publications

Pneumoperitoneum in a Patient with Endometriosis and Bilateral Salpingectomy after Sexual Activity

Pneumoperitoneum in a Patient with Endometriosis and Bilateral Salpingectomy after Sexual Activity

A case report of spontaneous pneumoperitoneum after sexual intercourse following a total laparoscopic hysterectomy, bilateral saplingo-oophorectomy and infra-colic omentectomy

Gastrointestinal Ultrasound (GIUS) in Intestinal Emergencies – An EFSUMB Position Paper

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