Abstract
Objective: Spontaneous pneumoperitoneum is a rare condition. It presents a challenge to the surgeon as the clinical presentation and radiological findings mimic perforated viscus resulting in unnecessary surgical intervention. The aim of this article is to describe a case of a spontaneous pneumoperitoneum in an elderly patient who underwent diagnostic laparoscopy and review of literature. Case presentation: A 77-year-old female with multiple comorbidities presented to the emergency department with productive cough, shortness of breath, vomiting and abdominal pain. On examination she had tenderness in epigastric region. Chest X-ray and CT showed free air and fluid in peritoneal cavity. Results: The patient underwent diagnostic laparoscopy that did not reveal any gastrointestinal perforation. Conclusion: Spontaneous pneumoperitoneum is frequently mistaken for perforated viscus. If the patient presents with features of peritonitis, diagnostic laparoscopy has a vital role as it prevents unnecessary midline laparotomy.
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