Idiopathic pneumoperitoneum a review of the literature and report of one case
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We have reviewed the literature with regard to the etiology of idiopathic pneumoperitoneum and have added the case of a 53 year old male with a history of symptoms referable to the gastrointestinal tract for the past 27 years. X-ray examination revealed the presence of free air beneath both leaves of the diaphragm with no demonstrable acute lesion of the GI tract. A 70% gastric retention at six hours and some old deformation of the duodenal bulb were the only positive findings. Some three months after the initial hospitalization the patient was again x-rayed and there was no evidence of free gas in the abdominal cavity.
Study of the British and American literature for the past twenty years would lead one to believe this an infrequently found condition. The foreign literature, however, suggest that there are many cases, the etiology of many of which is probably due to a cystic disease of the intestinal tract known as pneumotosis cystoides intestinalis. This pathology should be sought for more closely by the surgeon and pathologist in order to better determine the true etiology of idiopathic pneumoperitoneum.
KeywordsFresh Fruit Pyloric Stenosis Duodenal Bulb American Literature Veteran Administration Hospital
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