Conservative management of idiopathic pneumoperitoneum masquerading as peritonitis: Report of a case |
| |
Authors: | Tatsuo Tani Yoshio Shirai Mamoru Sasagawa Tsutomu Wanifuchi Kazuyoshi Yagi Iwao Satoh Katsuyoshi Hatakeyama |
| |
Institution: | (1) Department of Surgery, Niigata University School of Medicine, 1-757 Asahimachi-dori, 951 Niigata, Japan;(2) Department of Surgery, Nanbugoh General Hospital, 1404-1 Muramatsu, 959-17, Japan;(3) Department of Internal Medicine, Nanbugoh General Hospital, 1404-1 Muramatsu, 959-17, Japan |
| |
Abstract: | Pneumoperitoneum is most commonly caused by the perforation of a hollow viscus, in which case an emergency laparotomy is indicated. We report herein the case of a patient who, presented with the signs and symptoms of peritonitis, but who was found to have idiopathic pneumoperitoneum which was successfully managed by conservative treatment. A 70-year-old man presented with epigastric pain, nausea, and a severely distended and tympanitic abdomen. Abdominal examination revealed diffuse tenderness with guarding, but no rebound tenderness. He was febrile with leukocytosis and high C-reactive protein. Chest X-ray and abdominal computed tomography demonstrated a massive pneumoperitoneum without pneumothorax, pneumomediastinum, pneumortroperitoneum, or subcutaneous emphysema, and subsequent examinations failed to demonstrate perforation of a hollow viscus. Thus, a diagnosis of idiopathic pneumoperitoneum was made, and the patient was managed conservatively, which resulted in a successful outcome. This experience and a review of the literature suggest that idiopathic pneumoperitoneum is amenable to conservative management, even when the signs and symptoms of peritonitis are present. |
| |
Keywords: | spontaneous pneumoperitoneum idiopathic disease peritonitis conservative management |
本文献已被 SpringerLink 等数据库收录! |
|