|Classification and external resources|
Pneumoperitoneum is the presence of air or gas in the abdominal (peritoneal) cavity. It is often seen on X-ray, but small amounts are often missed, and CT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum. CT can visualize quantities as small as 5 cm³ of air or gas. The most common cause is a perforated abdominal viscus, generally a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma. A perforated appendix seldom causes a pneumoperitoneum.
In the mid-twentieth century, an "artificial" pneumoperitoneum was sometimes intentionally administered as a treatment for a hiatal hernia. This was achieved by insufflating the abdomen with carbon dioxide. The practice is currently used by surgical teams in order to perform laparoscopic surgery.
- Perforated duodenal ulcer - The most common cause of rupture in the abdomen. Especially of the anterior aspect of the first part of the duodenum.
- Perforated peptic ulcer
- Bowel obstruction
- Ruptured diverticulum
- Penetrating trauma
- Ruptured inflammatory bowel disease (e.g. megacolon)
- Necrotising enterocolitis/Pneumatosis coli
- Bowel cancer
- Ischemic bowel
- After laparotomy
- After laparoscopy
- Breakdown of a surgical anastomosis
- Bowel injury after endoscopy
- Peritoneal dialysis
- Vaginal insufflation (air enters via the fallopian tubes, e.g. water-skiing, oral sex)
- Colonic or peritoneal infection
- From chest (e.g. bronchopleural fistula)
- Non-invasive PAP (positive airway pressure) can force air down duodenum as well as down trachea.
- Ali Nawaz Khan. "eMedicine.com: Pneumoperitoneum".
- Necrotizing Enterocolitis Bugs, Drugs and Things That Go Bump in the Night
- Sexual Activity as Cause for Non-Surgical Pneumoperitoneum