Recurrent Idiopathic Spontaneous Pneumoperitoneum: A Case Report

Abstract

The most common cause of pneumoperitoneum is perforated hollow viscus, which generally necessitates emergent surgical intervention. Idiopathic spontaneous pneumoperitoneum (ISP) is a rare condition less commonly described. This report outlines the case of a 79-year-old male with recurrent idiopathic spontaneous pneumoperitoneum managed by repeated laparotomy. Knowledge of this rare phenomenon and appropriate workup may allow for the avoidance of unnecessary laparotomies. Despite this, definitively ruling out perforated hollow viscus is difficult outside of the operating room, and many patients will ultimately be taken for surgical exploration and definitive diagnosis.

Keywords: conservative management; general surgery; idiopathic spontaneous pneumoperitoneum; pneumoperitoneum; surgery.

Figure 1. Pneumoperitoneum (asterisk) seen on CT from the patient’s first admission (A) and second admission (B).