Aims: reporting a case of idiopathic pneumoperitoneum presented as an acute abdominal emergency with peritoneal signs.
Objectives: to discuss various aetiologies of pneumoperitoneum including non-surgical causes intrabdominal, intrathoracic, iatrogenic, rare case scenario of idiopathic spontaneous pneumoperitoneum and its management.
Case details: A 34 year old male presented with acute abdominal pain, vomiting and fever. Examination findings included diffuse abdominal tenderness, guarding and rigidity .leukocyte counts were normal, x-ray abdomen and chest showed air under both diaphragms. His medical history was unremarkable, no operative history or admissions previously. Patient was not on any medication, on smoker, non-alcoholic. Emergency laparotomy was performed no perforation of viscus was identified. Peritoneal wash was given and 3 drains placed. intraoperative peritoneal fluid sent for culture was sterile, patient subsequently recovered postoperatively and was stated orally on postoperative day 3 and was subsequently discharged on postoperative day 5, the cause of pneumoperitoneum remained obscure.
Conclusion: a thorough history physical examination, appropriate lab tests and imaging are useful tools in identifying patients with non-surgical causes of pneumoperitoneum, Idiopathic pneumoperitoneum is rare and diagnosed only after a laparotomy.
idiopathic pneumoperitoneum, idiopathic spontaneous pneumoperitoneum, surgical emergency, intrabdominal viscus, abdominal tenderness, guarding