Intraperitoneal free gas seen radiologically as air under the diaphragm nearly always indicates a perforated abdominal viscus that requires surgical intervention. Rarely, however, the presence of a pneumoperitoneum may not indicate an intra-abdominal perforation and thus may not require laparotomy. Such a situation is termed spontaneous or nonsurgical pneumoperitoneum. In this review, we explor...

Pneumoperitoneum is not always associated with hollow viscus perforation. Such condition is called non-surgical or spontaneous pneumoperitoneum. Intrathoracic causes remain the most frequently reported mechanism inducing this potentially life threatening complication. This clinical condition is associated with therapeutic dilemma. We report a case of a massive isolated pneumoperitoneum causing ...

We report a patient with pneumoperitoneum that recurred concomitantly with asthmatic exacerbation. The patient was a 71-year-old man with a medical history of bronchial asthma. Chest X-rays obtained during asthmatic exacerbation showed intra-abdominal air beneath his diaphragm. Subsequently, a computed tomography scan of his chest confirmed mediastinal emphysema and intra-abdominal air beneath ...

To cite: Patel RV, Kumar H, Patwardhan N, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013010447 DESCRIPTION A 4-month-old male infant developed respiratory distress, respiratory synchitial virus bronchiolitis with bilateral segmental collapse consolidation of upper zones requiring intraosseous vascular access with left tibial fracture, intubation and d...

BACKGROUND Tension pneumoperitoneum as a complication of iatrogenic bowel perforation during endoscopy is a dramatic condition in which intraperitoneal air under pressure causes hemodynamic and ventilatory compromise. Like tension pneumothorax, urgent intervention is required. Immediate surgical decompression though is not always possible due to the limitations of the preclinical management and...

The purpose of the present study was to evaluate the effect of increasing intra-abdominal pressure (IAP) on stroke volume variation (SVV) and plethysmographic variability index (PVI) in patients undergoing laparoscopic cholecystectomy. PVI examined by Masimo Radical 7 pulse oximeter and SVV determined using FloTrac/Vigileo were monitored simultaneously in forty-five patients undergoing laparosc...

PURPOSE The purpose of this study was to assess the effects of hyperventilation on patients undergoing laparoscopic surgeries on haemodynamics, partial pressure of carbon dioxide and acid base status. METHODS 60 patients undergoing laparoscopic surgeries under General Anaesthesia were randomized into two groups, "control group" ventilated with tidal volume of 10 ml/kg and respiratory rate of ...

This study aimed to explore the impact of gasless laparoscopy on circulation, respiration, stress response and other complications in gynecological surgery for old female patients. 40 patients (American Society of Anesthesiologists II-III, 60-70y) scheduled for elective gynecological laparoscopy were divided into non-pneumoperitoneum group (NP) and pneumoperitoneum group (P). All patients inclu...

An 82-year-old female presented to the emergency department with acute worsening of abdominal pain, which had been present for three months. Her physical exam showed significant signs of considerable abdominal distention, diffuse tenderness, and rigidity. She was unable to change position for upright abdominal radiographs; therefore, a modified portable flat plate abdominal radiograph was obtai...

OBJECTIVE To compare abdominal ultrasonography findings with plain radiography in the detection of postsurgical pneumoperitoneum. STUDY DESIGN Cross-sectional, observational. PLACE AND DURATION OF STUDY Radiology Department, PNS Shifa Hospital, Karachi, from October, 2005 to April, 2006. METHODOLOGY Thirty patients of either gender who underwent laparotomies were included in the study. Pa...