Idiopathic Spontaneous Pneumoperitoneum In A Healthy Adolescent.
EAES Academy. Chee S. 07/05/22; 363174; P219
Dr. Shu Ying Chee
Contributions
Contributions
Abstract
Introduction
Pneumoperitoneum is most often caused by a perforation of a hollow viscus and is often considered a surgical emergency. However, idiopathic spontaneous pneumoperitoneum is a rare condition that is characterized by intraperitoneal gas without gastrointestinal tract perforation, for which there is no clear identification of any etiology.
Methods
We describe a case of an 18-year-old female who presented to the emergency department with left shoulder tip pain and upper abdominal discomfort. On examination, her abdomen was soft and non-tender. She had an erect chest X-ray which showed air under the diaphragm indicative of a pneumoperitoneum. Subsequently, she had a CT abdomen pelvis which demonstrated pneumoperitoneum but the source could not be identified on imaging. She also had an OGD which was normal.
Results
She was well and vitally stable throughout her admission. She was monitored for 48 hours in hospital and was subsequently discharged home. She was followed up in our outpatient clinic two weeks after discharge and remained clinically well. Her repeat erect chest X-ray at the 2 weeks outpatient clinic visit showed complete resolution of her pneumoperitoneum.
Conclusion
A detailed medical history, physical examination, appropriate laboratory tests and radiological investigations are valuable tools to identify patients with non-surgical pneumoperitoneum. Knowledge of this rare disease will help in avoiding unnecessary laparotomy.
Pneumoperitoneum is most often caused by a perforation of a hollow viscus and is often considered a surgical emergency. However, idiopathic spontaneous pneumoperitoneum is a rare condition that is characterized by intraperitoneal gas without gastrointestinal tract perforation, for which there is no clear identification of any etiology.
Methods
We describe a case of an 18-year-old female who presented to the emergency department with left shoulder tip pain and upper abdominal discomfort. On examination, her abdomen was soft and non-tender. She had an erect chest X-ray which showed air under the diaphragm indicative of a pneumoperitoneum. Subsequently, she had a CT abdomen pelvis which demonstrated pneumoperitoneum but the source could not be identified on imaging. She also had an OGD which was normal.
Results
She was well and vitally stable throughout her admission. She was monitored for 48 hours in hospital and was subsequently discharged home. She was followed up in our outpatient clinic two weeks after discharge and remained clinically well. Her repeat erect chest X-ray at the 2 weeks outpatient clinic visit showed complete resolution of her pneumoperitoneum.
Conclusion
A detailed medical history, physical examination, appropriate laboratory tests and radiological investigations are valuable tools to identify patients with non-surgical pneumoperitoneum. Knowledge of this rare disease will help in avoiding unnecessary laparotomy.
Introduction
Pneumoperitoneum is most often caused by a perforation of a hollow viscus and is often considered a surgical emergency. However, idiopathic spontaneous pneumoperitoneum is a rare condition that is characterized by intraperitoneal gas without gastrointestinal tract perforation, for which there is no clear identification of any etiology.
Methods
We describe a case of an 18-year-old female who presented to the emergency department with left shoulder tip pain and upper abdominal discomfort. On examination, her abdomen was soft and non-tender. She had an erect chest X-ray which showed air under the diaphragm indicative of a pneumoperitoneum. Subsequently, she had a CT abdomen pelvis which demonstrated pneumoperitoneum but the source could not be identified on imaging. She also had an OGD which was normal.
Results
She was well and vitally stable throughout her admission. She was monitored for 48 hours in hospital and was subsequently discharged home. She was followed up in our outpatient clinic two weeks after discharge and remained clinically well. Her repeat erect chest X-ray at the 2 weeks outpatient clinic visit showed complete resolution of her pneumoperitoneum.
Conclusion
A detailed medical history, physical examination, appropriate laboratory tests and radiological investigations are valuable tools to identify patients with non-surgical pneumoperitoneum. Knowledge of this rare disease will help in avoiding unnecessary laparotomy.
Pneumoperitoneum is most often caused by a perforation of a hollow viscus and is often considered a surgical emergency. However, idiopathic spontaneous pneumoperitoneum is a rare condition that is characterized by intraperitoneal gas without gastrointestinal tract perforation, for which there is no clear identification of any etiology.
Methods
We describe a case of an 18-year-old female who presented to the emergency department with left shoulder tip pain and upper abdominal discomfort. On examination, her abdomen was soft and non-tender. She had an erect chest X-ray which showed air under the diaphragm indicative of a pneumoperitoneum. Subsequently, she had a CT abdomen pelvis which demonstrated pneumoperitoneum but the source could not be identified on imaging. She also had an OGD which was normal.
Results
She was well and vitally stable throughout her admission. She was monitored for 48 hours in hospital and was subsequently discharged home. She was followed up in our outpatient clinic two weeks after discharge and remained clinically well. Her repeat erect chest X-ray at the 2 weeks outpatient clinic visit showed complete resolution of her pneumoperitoneum.
Conclusion
A detailed medical history, physical examination, appropriate laboratory tests and radiological investigations are valuable tools to identify patients with non-surgical pneumoperitoneum. Knowledge of this rare disease will help in avoiding unnecessary laparotomy.
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