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The presence of pneumoperitoneum on plain films of the chest or abdomen usually indicates urgent laparotomy because pneumoperitoneum except for early postoperative condition of the abdominal surgery almost always means perforation of the gastrointestinal tract. Although the phenomenon is very rare, several patients of pneumoperitoneum without evidence of the gastrointestinal perforation have been recorded. Two types are considered to the development of this pneumoperitoneum ; one is so-called nonsurgical or medical pneumoperitoneum due to thoracic, abdominal, gynecologic or iatrogenic causes (several spontaneous cases have been included), and the other is infectious pneumoperitoneum due to proliferation of gas-producing microbes. Four cases have been experienced in our department of surgery and presented. One patient had nonsurgical pneumoperitoneum and the other three had pneumoperitoneum associated with severe infectious process. All of the patients were explored ; of course, no perforation of the abdominal viscera was demonstrated. As a rule, infectious pneumoperitoneum should be laparotomized because of concomitant peritonitis signs. But, if the perforation of the gastrointestinal tract was ruled out in spite of the presence of pneumoperitoneum, elective surgery against the original infectious process may be scheduled. Whereas, so-called nonsurgical pneumoperitoneum needs no emergency operation and the causes of pneumoperitoneum should be detected carefully.
近畿大学の論文
1983-06-25

<原著>消化管非穿孔性の気腹像について

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