Pneumothorax Causing Pneumoperitoneum: Role of Surgical Intervention

Abstract

The most common cause of a pneumoperitoneum is a perforation of a hollow viscus and the treatment is an exploratory laparotomy; nevertheless, not all pneumoperitoneums are due to a perforation and not all of them need surgical intervention. We hereby present a case of pneumoperitoneum due to a diaphragmatic defect, which allowed air from a pneumothorax to escape through the diaphragmatic hernia into the abdominal cavity.

Non‐surgical pneumoperitoneum and pneumoretroperitoneum associated with mechanical ventilation

“…In most instances, Pneumothorax leading to the development of pneumoperitoneum is reported in the presence of a diaphragmatic hernia. 3,4 Likewise development of pneumothorax after laparoscopic surgeries where pneumoperitoneum is induced was also reported. 5 In up to 90% of the cases of pneumoperitoneum bowel perforation is the usual cause.…”

Right-Sided Pneumothorax Associated with Pneumoperitoneum Subsequent to Transverse Colon Perforation: Case Report

“…However, our patient presented some risk factors for pneumothorax, including sleep apnea apparatus syndrome and COPD treated with a long-acting anticholinergic agent. Duarte et al reported a case of pneumoperitoneum without digestive perforation related to a massive bilateral pneumothorax explained by diaphragmatic defect [4].…”

“…Pneumothorax associated with pneumoperitoneum is a rare event [3,4]. The link between the presence of intrapleural and intraperitoneal air without mediastinal communication has not been demonstrated to date without iatrogenic cause [3,4]. It is usually related to malformation or diaphragmatic trauma [1,2].…”

Simultaneous pneumothorax and pneumoperitoneum as a late consequence of traumatic injury of the diaphragm: Multimodality imaging approach with surgical correlation and treatment

“…Up to now, only few cases have reported the concurrent manifestation of these two clinical entities in patients with specific diseases (ie, pleuroparenchymal fibroelastosis) or iatrogenic damages (ie, mechanical ventilation, gastro-esophageal anastomosis, aritificial pneumoperitoneum) [ 2 , [4] , [5] , [6] ].…”