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Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report
BACKGROUND: Pneumoperitoneum commonly occurs as a result of a viscus perforation and usually presents with peritoneal signs requiring emergent laparotomy. Spontaneous pneumoperitoneum is a rare condition characterized by intraperitoneal gas with no clear etiology. CASE PRESENTATION: We herein report...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944718/ https://www.ncbi.nlm.nih.gov/pubmed/31907703 http://dx.doi.org/10.1186/s40792-019-0769-4 |
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author | Ueda, Takeshi Tanaka, Tetsuya Yokoyama, Takashi Sadamitsu, Tomomi Harada, Suzuka Yoshimura, Atsushi |
author_facet | Ueda, Takeshi Tanaka, Tetsuya Yokoyama, Takashi Sadamitsu, Tomomi Harada, Suzuka Yoshimura, Atsushi |
author_sort | Ueda, Takeshi |
collection | PubMed |
description | BACKGROUND: Pneumoperitoneum commonly occurs as a result of a viscus perforation and usually presents with peritoneal signs requiring emergent laparotomy. Spontaneous pneumoperitoneum is a rare condition characterized by intraperitoneal gas with no clear etiology. CASE PRESENTATION: We herein report a case in which conservative treatment was achieved for an 83-year-old male patient with spontaneous pneumoperitoneum that probably occurred due to duodenal diverticulosis. He had stable vital signs and slight epigastric discomfort without any other signs of peritonitis. A chest radiograph and computed tomography showed that a large amount of free gas extended into the upper abdominal cavity. Esophagogastroduodenoscopy showed duodenal diverticulosis but no perforation of the upper gastrointestinal tract. He was diagnosed with spontaneous pneumoperitoneum, and conservative treatment was selected. His medical course was uneventful, and pneumoperitoneum disappeared after 6 months. CONCLUSION: In the management of spontaneous pneumoperitoneum, recognition of this rare condition and an accurate diagnosis based on symptoms and clinical imaging might contribute to reducing the performance of unnecessary laparotomy. However, in uncertain cases with peritoneal signs, spontaneous pneumoperitoneum is difficult to differentiate from free air resulting from gastrointestinal perforation and emergency exploratory laparotomy should be considered for these patients. |
format | Online Article Text |
id | pubmed-6944718 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-69447182020-01-23 Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report Ueda, Takeshi Tanaka, Tetsuya Yokoyama, Takashi Sadamitsu, Tomomi Harada, Suzuka Yoshimura, Atsushi Surg Case Rep Case Report BACKGROUND: Pneumoperitoneum commonly occurs as a result of a viscus perforation and usually presents with peritoneal signs requiring emergent laparotomy. Spontaneous pneumoperitoneum is a rare condition characterized by intraperitoneal gas with no clear etiology. CASE PRESENTATION: We herein report a case in which conservative treatment was achieved for an 83-year-old male patient with spontaneous pneumoperitoneum that probably occurred due to duodenal diverticulosis. He had stable vital signs and slight epigastric discomfort without any other signs of peritonitis. A chest radiograph and computed tomography showed that a large amount of free gas extended into the upper abdominal cavity. Esophagogastroduodenoscopy showed duodenal diverticulosis but no perforation of the upper gastrointestinal tract. He was diagnosed with spontaneous pneumoperitoneum, and conservative treatment was selected. His medical course was uneventful, and pneumoperitoneum disappeared after 6 months. CONCLUSION: In the management of spontaneous pneumoperitoneum, recognition of this rare condition and an accurate diagnosis based on symptoms and clinical imaging might contribute to reducing the performance of unnecessary laparotomy. However, in uncertain cases with peritoneal signs, spontaneous pneumoperitoneum is difficult to differentiate from free air resulting from gastrointestinal perforation and emergency exploratory laparotomy should be considered for these patients. Springer Berlin Heidelberg 2020-01-06 /pmc/articles/PMC6944718/ /pubmed/31907703 http://dx.doi.org/10.1186/s40792-019-0769-4 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Case Report Ueda, Takeshi Tanaka, Tetsuya Yokoyama, Takashi Sadamitsu, Tomomi Harada, Suzuka Yoshimura, Atsushi Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
title | Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
title_full | Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
title_fullStr | Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
title_full_unstemmed | Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
title_short | Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
title_sort | spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944718/ https://www.ncbi.nlm.nih.gov/pubmed/31907703 http://dx.doi.org/10.1186/s40792-019-0769-4 |
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