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How to distinguish between surgical and non-surgical pneumoperitoneum?


1Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové

2Department of Field Surgery, Military Health Science Faculty Hradec Králové Defence University Brno

DOI: 10.22514/SV91.042014.1 Vol.9,Issue 1,April 2014 pp.9-15

Published: 30 April 2014

*Corresponding Author(s): FILIP ČEČKA E-mail:


Not all cases of pneumoperitoneum found on abdominal X-ray or computed tomography (CT) scan are caused by hollow viscus perforation. Non-surgical or spontaneous pneumoperitoneum is a repeatedly described entity. However, not all physicians in emergency departments are aware of it, and in such cases unnecessary laparotomy is often performed which reveals no intra-abdominal pathology. Non-surgical pneumoperitoneum can have thoracic, abdominal, gynecological, or other causes. When we acknowledge the possibility of non-surgical pneumoperitoneum, the primary goal is to discern sur-gical from non-surgical pneumoperitoneum. Identifying cases in which laparotomy can be avoided is important to prevent unnecessary surgery and its associated morbidity and financial costs. In this paper we propose a practical algorithm which may help the attending physicians to distinguish between surgical and non-surgical pneumoperitoneum. 


non-surgical pneumo-peritoneum, postoperative pneumo-peritoneum, positive end-expiratory pressure, endoscopy, percutaneous endoscopic gastrostomy, peritoneal dialysis, postcoital pneumoperito-neum

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FILIP ČEČKA,OTAKAR SOTONA,ZDENÌK ŠUBRT. How to distinguish between surgical and non-surgical pneumoperitoneum?. Signa Vitae. 2014. 9(1);9-15.


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