pneumoperitoneumot

Pneumoperitoneum is the presence of free gas within the peritoneal cavity. The term pneumoperitoneumot is not standard in medical literature and may reflect a typographical variant of pneumoperitoneum; however, it is commonly understood to refer to the same condition. Free intraperitoneal air most often signals a breach of the gastrointestinal tract, but can also occur after abdominal procedures or from other non-surgical sources.

Causes: Perforated hollow viscus (peptic ulcer, diverticulitis, appendix perforation), post-surgical or post-procedural introduction of gas (laparoscopy, endoscopy, imaging studies), blunt or penetrating abdominal trauma, neonatal or postoperative states, ascites with spontaneous rupture, thoracic sources (pneumothorax with diaphragmatic rupture).

Clinical presentation ranges from acute abdomen with peritonitis to incidental radiographic finding in asymptomatic patients, especially after recent procedures. Diagnosis relies on imaging: upright chest and abdominal radiographs show free air under the diaphragm; CT abdomen/pelvis is more sensitive and can help identify the cause.

Management: depends on cause and patient stability. Suspected perforated viscus typically requires expedited surgical evaluation and often emergent laparotomy with source control, broad-spectrum antibiotics, and resuscitation. Nonoperative management may be appropriate in select stable patients with contained or non-surgical causes. Small, asymptomatic pneumoperitoneum after procedures may be observed with clinical monitoring.

Prognosis: varies widely; delayed diagnosis of perforation increases mortality. Early recognition and treatment of the underlying cause improve outcomes. In neonates and elderly, prognosis may be more guarded.