Pneumoperitoneum refers to the presence of free air in the abdominal cavity, typically indicating viscus perforation requiring urgent surgical intervention. Occasionally, pneumoperitoneum occurs without organ perforation, termed 'spontaneous' or 'non-surgical' pneumoperitoneum. We present the case of a 65-year-old male referred to the emergency department after a seizure episode. The patient reported no abdominal pain or fever, and examination revealed no other signs of peritonitis. An erect chest X-ray showed air under the diaphragm, and a subsequent computed tomography (CT) scan confirmed free intraperitoneal air in the abdomen. The patient underwent a prompt exploratory laparotomy to assess for abdominal perforation, but the findings were negative. He had an uneventful post-operative hospital course and was discharged nine days after admission. This case underlines the importance of considering spontaneous idiopathic pneumoperitoneum (SIP) in asymptomatic patients and discusses management options.
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| http://dx.doi.org/10.7759/cureus.55687 | DOI Listing |
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