title: Spontaneous Pneumoperitoneum due to Constipation.
abstract: We report a rare case of spontaneous pneumoperitoneum. An 82-year-old Japanese male patient was referred to our hospital because of constipation and abdominal pain. Abdominal computed tomography revealed a large amount of feces in the colon and rectum, and free air in the abdomen. Based on these findings, the patient was diagnosed with gastrointestinal perforation. Emergency exploratory laparotomy was performed. Neither perforation nor ischemic changes were recognized in the digestive tract. The patient's defecation was managed postoperatively until discharge on the 13th postoperative day. The authors assumed that free air, which was released after a mucosal injury due to the internal pressure caused by the presence of a large amount of feces in the colon and rectum, had penetrated the bowel wall through the bowel mucosa. We herein report the present case while also reviewing the pertinent literature.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Yamana
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Noritomi
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takeno
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Hashimoto
authors.initials: H
authors.lastname: Tatsuya
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimaoka
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Yamaguchi
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ishii
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
keywords: Abdominal pain; Constipation; Differentiation; Intestinal cystic pneumatosis; Spontaneous pneumoperitoneum