Postoperative spontaneous pneumoperitoneum

A case of spontaneous pneumoperitoneum (the sixth) is reported. This is similar to four of the other cases in which there is an accompanying chest condition. This case is unusual in that it followed an operative procedure with opening of the peritoneum but at such a late date that there could be no connection between this and the pathological condition present. It also parallels the picture of tension pneumothorax in that the condition became worse and also was relieved only by removal of the air. The presence of a connection between the bronchial tree and the peritoneum seems necessary, in view of the fact that at no time either before or after the operation were there any symptoms referable to the gastrointestinal tract. Also, as is seen in tension pneumothorax, the release of the air resulted in a breaking of the vicious cycle and spontaneous recovery. Subsidence occurred spontaneously after removal of part of the air.