Idiopathic Spontaneous Pneumoperitoneum: When Not to Operate


Idiopathic Spontaneous Pneumoperitoneum: When Not to Operate


Giang Quach D.O.1, Sahithi Gogineni M.D.2, Chadi Faraj D.O. 3,  Abby Navratil M.D.4

1McGaw Medical Center of Northwestern University, Chicago, IL
2Wayne State University School of Medicine- Detroit, MI
3,4 Beaumont Hospital- Trenton/Dearborn, MI


International-Journal-of-Case-Reports-2d code

Pneumoperitoneum is often a surgical emergency related to gastrointestinal tract perforation.  On rare occasions, free intraperitoneal air can be present without any discernible cause and is considered Idiopathic Spontaneous Pneumoperitoneum (ISP).  Deciding which patients with ISP can be managed conservatively would help prevent some patients from undergoing unnecessary surgery. We describe here two cases of successful management of ISP and the review of literature of ISP management for the past 29 years. In the first case, a patient with ISP with no significant abdominal symptoms was successfully managed nonoperatively. In the second case, a patient with ISP and symptoms of small bowel obstruction was successfully treated surgically with exploratory laparotomy and small bowel resection. We recommend conservative management for the subset of ISP patients with no sign of peritonitis or sepsis.


Keywords: Idiopathic Spontaneous Pneumoperitoneum (ISP),  perforated viscous, pneumatosis intestinalis, non-surgical pneumoperitoneum

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How to cite this article:

Giang Quach, Sahithi Gogineni, Chadi Faraj, Abby Navratil. Idiopathic Spontaneous Pneumoperitoneum: When Not to Operate. International Journal of Case Reports, 2019 4:94. DOI: 10.28933/ijcr-2019-08-1705


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