[Monosymptomatic pneumoperitoneum is not an indication for surgery].

Pneumoperitoneum results from a perforation of the gastrointestinal tract in the majority of instances and the necessity for surgery is involved. In some cases with monosymptomatic pneumoperitoneum, surgery is unnecessary. A case of a man aged 64 with great amount of free intraperitoneal air is presented. The patient was clinically unaffected and had neither fever nor signs of peritoneal affection. The intraperitoneal air decreased slowly and disappeared after about 60 days. A self-sealing perforation of a duodenal ulcer was the cause of pneumoperitoneum. The most common causes of non-surgical pneumoperitoneum (PP) are discussed.

CONCLUSIONS

Monosymptomatic PP is not an indication for emergency surgery. If the patient has no signs of peritoneal reactions conservative treatment can be considered.