Abstract
Pneumoperitoneum is often caused by perforation of hollow viscera, but when an etiology is not identified, it is said to be idiopathic. It is considered a rare condition, as in the last 30 years, just over 20 cases have been described. We present a rare case of an incidental finding of a pneumoperitoneum in a 36 years old female patient.
Highlights
Idiopathic spontaneous pneumoperitoneum (ISP) is an unusual condition, which is characterized by the presence of gas in the intraperitoneal space without gastrointestinal perforation
This study reports an unusual presentation of an idiopathic pneumoperitoneum which has put the surgeon in a massive diagnostic and therapeutic challenge with a 36 year old patient with spontaneous idiopathic pneumoperitoneum
A 36-year-old female patient searched emergency care due to chest and shoulder pain associated with mild abdominal discomfort
Summary
Idiopathic spontaneous pneumoperitoneum (ISP) is an unusual condition, which is characterized by the presence of gas in the intraperitoneal space without gastrointestinal perforation. A 36-year-old female patient searched emergency care due to chest and shoulder pain associated with mild abdominal discomfort. The patient reported having sexual intercourse 96 hours before the onset of symptoms On examination, she was in good general condition, hemodynamically stable, with no changes in cardiac and pulmonary auscultation, flabby abdomen, little pain on diffuse palpation, sudden negative decompression negative. In view of the findings, the patient was asked to complete the exam with oral contrast and was later submitted to a new tomography and there was no contrast extravasation Laboratory tests such as blood count, Creactive protein, kidney and liver function showed no changes. Upper gastrointestinal endoscopy was performed 96 hours after admission without signs of micro perforation or changes in fundoplication Based on these findings, we diagnosed the patient with ISP. She was discharged asymptomatic from the hospital after 7 days under follow-up
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