Chronic, Massive Pneumoperitoneum in a Patient without Signs of Peritonitis

Author(s): Matt Kubina and Mohamad Mouchli

Pneumoperitoneum is the presence of air in the abdomen. This can be due to a wide variety of etiologies, many of which are surgical emergencies, yet it can also present as a chronic symptom of underlying pathology. Pneumoperitoneum can be due to primary (idiopathic) or secondary causes, of which the causes are numerous. This can even be due to other pathology unrelated to the GI tract, such as pathology of the thoracic cavity. We present a case of chronic pneumatosis intestinalis that was due to peritoneal blebs likely secondary to an alveolar-peritoneal fistula through the right hemidiaphragm.