Pneumoperitoneum: Causes & Reasons

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Possible Causes for pneumoperitoneum

Laparoscopy

We collected data to compare using this new method of peritoneal insufflation with using Palmer's point for pneumoperitoneum. [ncbi.nlm.nih.gov]

Take the patient out of Trendelenburg position in order to optimize the decompression of the pneumoperitoneum. [gfmer.ch]

METHODS: We introduced a new point for Veress needle insertion to create pneumoperitoneum during difficult laparoscopic procedures. [ncbi.nlm.nih.gov]

Small Bowel Obstruction

[…] clinical and/or CT-scan findings predictive for a surgical treatment (free peritoneal fluid, mesenterial edema, transitional point) or a peritonitis (pneumatosis intestinalis, pneumoperitoneum [ncbi.nlm.nih.gov]

[…] of bowel ischaemia or perforation included: (1) decreased bowel wall enhancement, (2) pneumatosis intestinalis, (3) portal venous gas, and (4) bowel wall perforation with pneumoperitoneum [journals.plos.org]

A large volume pneumoperitoneum secondary to bowel perforation in ASBO can also be detected on plain X-rays, preferably by an erect chest X-ray. [wjes.biomedcentral.com]

Gastric Rupture

She was diagnosed with a massive tension pneumoperitoneum, which was decompressed by needle aspiration. [ncbi.nlm.nih.gov]

We recently encountered two cases of gastric rupture with tension pneumoperitoneum that occurred after difficult endotracheal intubation. [ncbi.nlm.nih.gov]

Inadvertent esophageal intubation during cardiopulmonary resuscitation following aortocoronary bypass grafting resulted in gastric rupture and tension pneumoperitoneum in [ncbi.nlm.nih.gov]

Tubo-Ovarian Abscess

The chest X-rays revealed the pneumoperitoneum. [ncbi.nlm.nih.gov]

A case of tubo-ovarian abscess (TOA) presenting with pneumoperitoneum is unusual. [unboundmedicine.com]

PID, STIs 4 2020 Pneumoperitoneum secondary to tubo-ovarian abscess: A case report. [allie.dbcls.jp]

Intestinal Perforation

An abdominal X-ray demonstrated extensive PI with pneumoperitoneum mimicking hollow organ perforation. [ncbi.nlm.nih.gov]

We present two cases of pneumoperitoneum to discuss the non-surgical management of pneumoperitoneum and describe their outcomes. [afrjpaedsurg.org]

AIM: In view of recent studies questioning the usefulness of peritoneal drainage (PD) in premature neonates with pneumoperitoneum, suggesting approximately 75% of those treated [ncbi.nlm.nih.gov]

Pneumothorax

After the start of carbon dioxide-induced pneumoperitoneum, the patient's end-tidal carbon dioxide pressure and heart rate suddenly increased. [ncbi.nlm.nih.gov]

We present a case of a patient in whom subcutaneous emphysema, pneumoperitoneum, and pneumothorax occurred on postoperative day 1 after robotic-assisted supracervical hysterectomy [ncbi.nlm.nih.gov]

Less commonly, air can encircle the heart, (Pneumopericardium), get under the skin, (Subcutaneous Emphysema), leak into the abdomen (Pneumoperitoneum) or surround the kidneys [unitypoint.org]

Jejunal Diverticulosis

[…] of jejunal diverticulosis with pneumoperitoneum from the literature. [ncbi.nlm.nih.gov]

Pneumoperitoneum is documented over the course of many years, with recurrence after partial small bowel resection. [ncbi.nlm.nih.gov]

Although spontaneous pneumoperitoneum due to jejunal diverticulosis is a rare finding, when it does occur, this condition must be distinguished from other forms of pneumoperitoneum [ncbi.nlm.nih.gov]

Colonic Perforation

Abdominal computed tomography scan showed extensive pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum, and leftsided pneumothorax. [ncbi.nlm.nih.gov]

In the first patient the computerized tomography revealed pneumoperitoneum, gas in the mesosigma, pneumomediastinum, wall thickening of the descending colon, and retroperitoneal [ncbi.nlm.nih.gov]

Chest X-ray showed a pneumoperitoneum, which was an indication for emergency surgery. The patient had a laparotomy approach five hours after perforation. [ghrnet.org]

Cardiopulmonary Resuscitation

Pneumomediastinum/oesophagus haematoma, n 4 — — Pleural fluid/blood, n 1 3 3 Lung contusion/haematoma, n 1 — 1 Liver rupture, n 1 2 — Intracranial air embolism, n 1 — — Pneumoperitoneum [academic.oup.com]

Diverticulitis of the Colon

[…] fistula bowel: coloenteric fistula or colocolic fistula skin: colocutaneous fistula small bowel obstructions from adhesions or bowel wall edema perforation resulting in pneumoperitoneum [radiopaedia.org]

Intravenous and rectal contrast-enhanced axial CT of the abdomen showing diverticulitis with multiple abscesses (arrow) in the inframesocolic region and pneumoperitoneum, [scielo.br]

[…] there is evidence of extraluminal contrast (red arrow) from a perforated diverticulum, Conventional Radiography Sentinel loop or, less likely, LBO Air bubbles in abscess Pneumoperitoneum [learningradiology.com]

Intestinal Infarction

Splanchnic mucosal ischaemia: An unrecognized consequence of routine pneumoperitoneum. [journalofmas.com]

Splanchnic mucosal ischemia. an unrecognized consequence of routine pneumoperitoneum. Surg Laparosc Endosc 1997;7:480–482. CrossRef PubMed Google Scholar 44. [doi.org]

[…] pneumobilia because gas usually reaches the periphery of the liver while pneumobilia is usually about 2 cm short of external liver border, and is more clustered at the hilum pneumoperitoneum [radiopaedia.org]

Acute Peritonitis

[…] hemodynamic stability, there are no contraindication to create a pneumoperitoneum when LAPSaroscopic surgery is applicable in cases of peritonitis [wjes.biomedcentral.com]

Abdominal X-rays may reveal dilated, edematous intestines, although such X-rays are mainly useful to look for pneumoperitoneum, an indicator of gastrointestinal perforation [en.wikipedia.org]

As for peritonitis, there is a theoretical concern that the CO 2 pneumoperitoneum may enhance bacteremia and endotoxemia due to the increased intraperitoneal pressure [ 25 [wjes.biomedcentral.com]

Pneumoperitoneum

[…] in the assessment of a pneumoperitoneum. [en.wikipedia.org]

An erect chest X-ray revealed a small right pneumoperitoneum and the CAPD fluid contained 100 leucocytes/mL. [ncbi.nlm.nih.gov]

Plain chest/abdominal radiograph or computed tomographic scan of the abdomen can be diagnostic of pneumoperitoneum. [ncbi.nlm.nih.gov]

Pneumatosis Cystoides Intestinalis

PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. [ncbi.nlm.nih.gov]

Fig 1 CT scan shows diffuse intramural gas with suspected pneumoperitoneum. a Collection of intaluminal gas in PCI appearing like pneumoperitoneum. b Gas lining the bowel [surgicalcasereports.springeropen.com]

Based on the images, a clinical diagnosis of pneumatosis cystoides intestinalis with pneumoperitoneum was made. [ncbi.nlm.nih.gov]

Ulcerative Colitis

36%) Plain X-rays are often normal or show non-specific findings. [25] In a series of 73 patients, plain abdominal radiography (56%) showing colic distension in 53% or a pneumoperitoneum [en.wikipedia.org]

Duodenal Ulcer Perforation

The diagnosis of peptic ulcer perforation was made by clinical history and chest x-ray revealing free pneumoperitoneum [Figure 1]. [jdeonline.in]

A chest film (Panel A) showed bilateral pneumoperitoneum (arrows). An exploratory laparotomy revealed a perforated duodenal ulcer with callous borders (Panel B). [nejm.org]

Gas under diaphragm (pneumoperitoneum) was found in 67 (95.71%). [scopemed.org]

Lymphangioleiomyomatosis

[…] loss Blood in sputum Headache Pain abdomen Complications Ascites Pleural effusion pneumothorax Chylothorax H emoptysis Chyloptysis Chyluria Haematuria Pericardial effusion Pneumoperitoneum [wikidoc.org]

Intradermal Injection of Indigo Carmine for Sentinel Node Mapping - 2013 Effects of high positive end-expiratory pressure on haemodynamics and cerebral oxygenation during pneumoperitoneum [medicine.gachon.ac.kr]

[…] hemorrhage. [19] Other complications of lymphangioleiomyomatosis (LAM) include the following: Hemoptysis Chylothorax Ascites Chyloptysis Chyluria Hematuria Pericardial effusion Pneumoperitoneum [emedicine.medscape.com]

Gastropathy

Protein-losing gastropathy is a rare entity. Unlike the disease in adults, it usually is benign and self-limited in children. The aetiological contribution of cytomegalovirus has been insufficiently documented and the immunological status of patients was rarely described in most reports. The authors report an 11-year-old[…] [ncbi.nlm.nih.gov]

Ischemic Bowel Disease

[…] edema, ascites *pitfall : to assume alternate Dx like infectious colitis when you get the non-specific early findings of mesenteric ischemia Late CT Findings: pneumatosis, pneumoperitoneum [emergencymedicinecases.com]

Mediastinal Emphysema

We describe a 36 year-old man with SLE, complicated by bilateral pneumothorax, mediastinal emphysema and pneumoperitoneum. [ncbi.nlm.nih.gov]

I thought it was pneumoperitoneum! I blame my mistake on no readers with a small phone! Great case! Why was the patient tachycardic and hypotensive? [ultrasoundoftheweek.com]

Toxic Megacolon

[…] more likely to have pneumoperitoneum. [wikiradiography.net]

There may be signs of pneumoperitoneum if dilatation has progressed to cause perforation. barium studies and colonoscopy should be avoided, due to the risk of perforation [radiopaedia.org]

If perforation occurs, radiographic signs of a pneumoperitoneum may be apparent on the supine and/or lateral decubitus radiographs. [13] Clinical examination is not accurate [emedicine.medscape.com]

Acute Emphysematous Cholecystitis

Association with pneumoperitoneum is very rare and the finding of a macroscopic perforation of the gallbladder is possible only in a few cases. [ncbi.nlm.nih.gov]

Conclusion Spontaneous pneumoperitoneum is an extremely rare finding in pneumo-cholecystitis. [npplweb.com]

In addition, a CT scan may demonstrate additional important imaging findings such as air outside the gallbladder wall or lumen, pneumoperitoneum, due to perforation of the [ijcasereportsandimages.com]

Penetrating Abdominal Trauma

TECHNIQUE: After having established pneumoperitoneum and ports placement, the source of bleeding is identified and controlled. [ncbi.nlm.nih.gov]

Esophageal Perforation

Despite there are few reports of massive gastric distension causing gastric rupture and pneumoperitoneum after CPR, pneumoperitoneum and esophageal rupture has been rarely [austinpublishinggroup.com]

Five patients required additional interventions: four tube thoracostomies for pneumothoraces and one peritoneal drain for pneumoperitoneum. [ncbi.nlm.nih.gov]

A CT scan showed a mediastinal abscess, a right pleural effusion associated with a pneumoperitoneum and peritoneal effusion. Then the patient was transferred to us. [ejcts.oxfordjournals.org]

Peptic Ulcer

Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS [ncbi.nlm.nih.gov]

Perforation is usually a straightforward diagnosis, often with abundant pneumoperitoneum visible. [radiopaedia.org]

The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls [ncbi.nlm.nih.gov]

Anaerobic Bacterial Infection

Article 167 Downloads 8 Citations Abstract The increased recovery of anaerobic bacteria in clinical infection has led to greater appreciation of these organisms in ocular infections. In studies that employed adequate method for recovery of anaerobes they were isolated from about a third of patients with[…] [link.springer.com]

Subcutaneous Emphysema

A benign pneumoperitoneum associated with an extensive pneumatosis intestinalis is a rare complication after organ transplantation and should be treated conservatively. [ncbi.nlm.nih.gov]

Plain radiographs of the chest and abdomen revealed subcutaneous emphysema, pneumoperitoneum and pneumomediastinum. [pancreas.imedpub.com]

He had massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum on admission, and died from hypoxic [ncbi.nlm.nih.gov]

Catamenial Pneumothorax

Three women with pneumoperitoneum concomitant to CP. Thoracic/abdominal computed tomography scans and chest x-rays. Presence of pneumoperitoneum coexisting with CP. [ncbi.nlm.nih.gov]

We report a rare case of CP complicated with multiple diaphragmatic perforations as the only thoracoscopy finding, and also with right-side isolated pneumoperitoneum confirmed [ncbi.nlm.nih.gov]

The fourth patient had indirect evidence of diaphragmatic defects proven by a diagnostic pneumoperitoneum. [ncbi.nlm.nih.gov]

Perforated Peptic Ulcer

Pneumoperitoneum and peritonitis were documented, but the symptoms were mild. The "board-like abdomen" sign was not noted. [ncbi.nlm.nih.gov]

A chest radiograph revealed a large pneumoperitoneum. She underwent emergent laparoscopic omental patch repair of a perforated ulcer on the anterior wall of her stomach. [ncbi.nlm.nih.gov]

Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS [ncbi.nlm.nih.gov]

Perforated Diverticulitis

Fig. 8.5 Colonic perforation: evidence of pneumoperitoneum and air bubbles preferentially located in the pericolic fat ( arrows ) In case of free perforation into the peritoneal [radiologykey.com]

Perforated Diverticulum Plain film Pneumoperitoneum secondary to perforation of diverticulum. [stritch.luc.edu]

One of the reasons is related to a hypothetical risk of increased bacteraemia and hypercapnia due to the pressure of the pneumoperitoneum [ 47, 48 ]. [karger.com]