title: Pneumoperitoneum in a patient with pneumothorax and blunt neck trauma.
abstract: BACKGROUND
  Blunt trauma as a cause of pneumoperitoneum is less frequent and its occurrence without a ruptured viscus is rarely seen.
  
  
  METHODS
  We report a case of blunt neck trauma in which a motorcycle rider hit a fixed object causing severe laryngotracheal injury. The patient developed pneumothorax bilaterally and had pneumoperitoneum despite no injury to the internal viscus. Bilateral chest tube drainage and abdominal exploratory laparotomy was performed.
  
  
  CONCLUSIONS
  Free air in the abdomen after blunt traumatic neck injury is very rare. If pneumoperitoneum is suspected in the presence of pneumothorax, exploratory laparotomy should be performed to rule out intraabdominal injury. As, there is no consensus for this plan yet, further prospective studies are warrant. Conservative management for pneumoperitoneum in the absence of viscus perforation is still a safe option in carefully selected cases.
authors.affiliation: Trauma Surgery Section, Hamad General Hospital, Doha, Qatar.
authors.forename: Suhail Yaqoob
authors.initials: SY
authors.lastname: Hakim
authors.affiliation: Trauma Surgery Section, Hamad General Hospital, Doha, Qatar. Electronic address: traumaresearch@hmc.org.qa.
authors.forename: Husham
authors.initials: H
authors.lastname: Abdelrahman
authors.affiliation: Trauma Surgery Section, Hamad General Hospital, Doha, Qatar.
authors.forename: Insolvisagan Natesa
authors.initials: IN
authors.lastname: Mudali
authors.affiliation: Clinical Medicine, Weill Cornell Medical College, Doha, Qatar; Clinical Research, Trauma Section, Hamad General Hospital, Doha, Qatar.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Trauma Surgery Section, Hamad General Hospital, Doha, Qatar.
authors.forename: Ruben
authors.initials: R
authors.lastname: Peralta
authors.affiliation: Trauma Surgery Section, Hamad General Hospital, Doha, Qatar.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
keywords: Blunt trauma; Laryngotracheal injury; Pneumoperitoneum; Pneumothorax