경희대학교
의과대학 외과학교실
이성은*·고영관*·이석환·이상목·고석환·윤
충·주흥재
Three
Cases of Spontaneous Pneumoperitoneum
Seong
Eun Lee, M.D*, Young Gwan Ko. M.D*, Seok
Hwan Lee, M.D, Sang Mok Lee, M.D.,
Suck Hwan Koh, M.D, Choong
Yoon, M.D, Hoong Zae Joo, M.D.
Department
of Emergency Medicine*. and General Surgery.
College of Medicine, Kyung Hee University,
Seoul, Korea
Pneumoperitoneum
is usually the result of hollow viscus perforation with associated peritonitis.
Nonsurgical spontaneous pneumoperitoneum incidental to intrathoracic, intra-abdominal,
gyneco1ogic, iatrogenic, and other miscellaneous causes not associate with perforated
viscus has been documented in the literature. Three cases of spontaneous pneumoperitoneum
admitted to Kyung Hee University Hospital were experienced from Jan. 1997 to Sep.
1997. First patient with pneumoperitoneum was managed conservatively. Second Patients
with pneumoperitoneum underwent an exploratory 1aparotomy when clinical examination
suggested an acute abdomen; no intra-abdominal pathology was documented in this
case. Third patient, on ventilatory support after CPR, was managed conservatively
after performing a diagnostic peritoneal lavage that was negative.
There
were no cases of radiographically misdiagnosed pneumoperitoneum. Pneumoperitoneum
preceded by a reasonable incidental cause in a patient with an adequate abdominal
examination may warrant continued observation, Thus avoiding an unnecessary laparotomy.
Key
Word : Spontaneous pneumoperitoneum |
