title: Spontaneous pneumoperitoneum: diagnostic and management difficulties.
abstract: Acute abdominal pain is a common presentation to the ED. Most patients undergo a chest radiograph as part of their initial investigations, which occasionally reveals pneumoperitoneum. Pneumoperitoneum on imaging suggests a perforated hollow abdominal viscus and therefore often constitutes a surgical emergency. However, if the patient is neither peritonitic nor septic a management dilemma is faced. Some cases of pneumoperitoneum might be managed conservatively thus avoiding unnecessary laparotomy. We present a case of recurrent spontaneous pneumoperitoneum with abdominal pain that was managed conservatively and discuss the possible aetiologies and management issues of spontaneous pneumoperitoneum.
authors.affiliation: Emergency Department, University Hospital Birmingham NHS Trust, Birmingham, UK. carolinemmann@yahoo.co.uk
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Mann
authors.forename: Chandra S
authors.initials: CS
authors.lastname: Bhati
authors.forename: David
authors.initials: D
authors.lastname: Gemmell
authors.forename: Peter
authors.initials: P
authors.lastname: Doyle
authors.forename: Vibhore
authors.initials: V
authors.lastname: Gupta
authors.forename: David F
authors.initials: DF
authors.lastname: Gorman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004638:Emergency Treatment / Q000379:methods; D006801:Humans; D008297:Male; D011027:Pneumoperitoneum / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*