Review article

How to distinguish between surgical and non-surgical pneumoperitoneum?

FILIP ČEČKA ; Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
OTAKAR SOTONA ; Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
ZDENÌK ŠUBRT ; Department of Field Surgery, Military Health Science Faculty Hradec Králové, Defence University Brno, Czech Republic

Abstract

Not all cases of pneumoperitoneum found on abdominal X-ray or computed tomography (CT) scan are caused by hollow
viscus perforation. Non-surgical or spontaneous pneumoperitoneum is a repeatedly described entity. However, not all
physicians in emergency departments are aware of it, and in such cases unnecessary laparotomy is often performed which
reveals no intra-abdominal pathology. Non-surgical pneumoperitoneum can have thoracic, abdominal, gynecological, or
other causes. When we acknowledge the possibility of non-surgical pneumoperitoneum, the primary goal is to discern surgical
from non-surgical pneumoperitoneum. Identifying cases in which laparotomy can be avoided is important to prevent
unnecessary surgery and its associated morbidity and financial costs. In this paper we propose a practical algorithm which
may help the attending physicians to distinguish between surgical and non-surgical pneumoperitoneum.

Keywords

non-surgical pneumoperitoneum; postoperative pneumoperitoneum; positive end-expiratory pressure; endoscopy; percutaneous endoscopic gastrostomy; peritoneal dialysis; postcoital pneumoperitoneum

Hrčak ID:

134064

URI

https://hrcak.srce.hr/134064

Publication date:

1.10.2013.

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