The authors studied the literature for similar findings in order to try to classify the different types of pneumoperitoneum when they had a case of pneumoperitoneum of genital origin. They then went on to study the mechanism by which these rare cases of genital pneumoperitoneum occurred: the insufflation or aspiration of air through the tubes, tubal antiperistalsis and uterine or vaginal perforations. From the clinical angle it is essential to eliminate pneumoperitoneum secondary to perforation of a hollow organ, and then to look for signs of peritonitis which only occur in genital pneumoperitoneum due to uterine perforation. The case usually cures spontaneously but recurrences are not uncommon. If there are no signs of peritonitis expectant treatment should usually be undertaken.
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