Spontaneous pneumoperitoneum occurring during post-partum exercises in the knee-chest position

Lozman, Harvey; Newman, Arthur J.

doi:10.1016/0002-9378(56)90181-8

Cited by 40 publications

(9 citation statements)

References 3 publications

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“…During menses the dissolving cervical mucus plug may allow the ascent of air through the fallopian tubes into the abdomen and through diaphragmatic fenestrations into the thorax [18]. Spontaneous postpartum pneumoperitoneum and postcoital pneumothorax have also been reported [19, 20]. The theory of transfallopian ascent of air is supported by the report that plication of diaphragmatic perforations and tubal ligation have cured catamenial pneumothorax [21].…”

Section: Pathogenesismentioning

confidence: 99%

Thoracic Endometriosis Syndrome

Augoulea

Lambrinoudaki²,

Christodoulakos³

2007

Respiration

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Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity and is usually confined to the pelvis. Thoracic endometriosis syndrome (TES) is a rare disorder characterized by the presence of functioning endometrial tissue in the pleura, the lung parenchyma and the airways. TES may present with hemoptysis, due to the shedding of endometrial tissue in the bronchial tree, or spontaneous pneumothorax or hemothorax if the endometrial tissue is localized peripherally. Patients are of reproductive age, often nulliparous, with long-standing symptoms. The crucial issue for establishing the diagnosis is the cyclicity of the symptoms which occur along with the menstrual cycle. TES is virtually a diagnosis of exclusion, established on clinical grounds, since neither CT nor endoscopy are specific for TES. Treatment consists of gonadotropin-releasing hormone analogues, aiming to suppress the hypophyseal-gonadal axis, so as to ensure a regression of the endometrial implants. If medical treatment fails, surgical resection of the endometriomas is suggested, although relapse rate may be high.

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Section: Pathogenesismentioning

confidence: 99%

Thoracic Endometriosis Syndrome

Augoulea

Lambrinoudaki²,

Christodoulakos³

2007

Respiration

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“…Vaginal douching, insufflation, and even pelvic inflammatory disease have been associated with non-surgical pneumoperitoneum [3]. Several bizarre incidences of SP have been documented after jacuzzi usage [12], scuba diving [13], and even knee-chest exercises [14]. Finally, there are cases of SP that demonstrate no clear risk factors or cause for the presence of intraperitoneal free air with subsequent negative laparotomies; these are labeled idiopathic pneumoperitoneum [15].…”

Section: Discussionmentioning

confidence: 99%

Massive Pneumoperitoneum Presenting as an Incidental Finding

Wang

Batra

2018

Cureus

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Pneumoperitoneum is often associated with surgical complications or intra-abdominal sepsis. While commonly deemed a surgical emergency, pneumoperitoneum in a minority of cases does not involve a viscus perforation or require urgent surgical management; these cases of “spontaneous pneumoperitoneum” can stem from a variety of etiologies. We report a case of a 72-year-old African American male with a history of metastatic pancreatic adenocarcinoma who presented with new-onset abdominal distention and an incidentally discovered massive pneumoperitoneum with no clear source of perforation on surveillance imaging. His exam was non-peritonitic, so no surgical intervention was recommended. He was treated with bowel rest, intravenous antibiotics, and hydration. He had a relatively benign clinical course with preserved gastrointestinal function and had complete resolution of his pneumoperitoneum on imaging two months after discharge. This case highlights the importance of considering non-surgical causes of pneumoperitoneum, as well as conservative management, when approaching patients with otherwise benign abdominal exams.

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“…Pneumoperitoneum of unknown origin often leads to an explorative surgery in the intensive care unit setting 26. Gynaecological causes for pneumoperitoneum, such as sexual intercourse after hysterectomy or exercises postpartum, also exist 27 28…”

Section: Discussionmentioning

confidence: 99%

Two similar cases of elderly women with moderate abdominal pain and pneumoperitoneum of unknown origin: a surgeon's successful conservative management

et al. 2016

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Patients presenting with abdominal pain and pneumoperitoneum in radiological examination usually require emergency explorative laparoscopy or laparotomy. Pneumoperitoneum mostly associates with gastrointestinal perforation. There are very few cases where surgery can be avoided. We present 2 cases of pneumoperitoneum with unknown origin and successful conservative treatment. Both patients were elderly women presenting to our emergency unit, with moderate abdominal pain. There was neither medical intervention nor trauma in their medical history. Physical examination revealed mild abdominal tenderness, but no clinical sign of peritonitis. Cardiopulmonary examination remained unremarkable. Blood studies showed only slight abnormalities, in particular, inflammation parameters were not significantly increased. Finally, obtained CTs showed free abdominal gas of unknown origin in both cases. We performed conservative management with nil per os, nasogastric tube, total parenteral nutrition and prophylactic antibiotics. After 2 weeks, both were discharged home.

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Spontaneous pneumoperitoneum occurring during post-partum exercises in the knee-chest position

Cited by 40 publications

References 3 publications

Thoracic Endometriosis Syndrome

Thoracic Endometriosis Syndrome

Massive Pneumoperitoneum Presenting as an Incidental Finding

Two similar cases of elderly women with moderate abdominal pain and pneumoperitoneum of unknown origin: a surgeon's successful conservative management

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