Pneumoperitoneum without Hollow Organ Perforation: A Case Report

無臟器穿孔之腹腔積氣：一病例報告

陳威廷(Wei-Ting Chen)；李彬州(Bin-Chou Lee)；蔡孟叡(Meng-Jui Tsai)

腹腔積氣 ； 穿孔 ； 剖腹探查 ； pneumoperitoneum ； perforation ； laparotomy

Journal of Emergency Medicine, Taiwan

13卷1期（2011 / 03 / 01）

48 - 52

英文

腹腔積氣常被認為跟臟器穿孔有關，必須緊急外科照會及開刀處理，但有百分之十的腹腔積氣找不到臟器穿孔的證據，這類的腹腔積氣被稱為自發性腹腔積氣。目前自發性腹腔積氣的處理對外科來說，還是處於進退兩難的選擇。我們這裡報告一位發燒及腹痛的30歲女性，經X光發現腹腔積氣照會外科行剖腹探查手術，但沒發現任何臟器穿孔之證據。

Pneumoperitoneum is almost always interpreted as evidence of visceral perforation and is an indication for immediate surgical intervention. Spontaneous, nonsurgical or idiopathic pneumoperitoneum indicates a condition in which evidence of visceral perforation cannot be found even with radiological evidence of pneumoperitoneum. Spontaneous pneumoperitoneum has been reported in 10% of all cases and is a surgical dilemma which requires proper assessment with a thorough history and physical examination. We report a 30-year-old woman suffered abdominal pain and fever with radiographically proven pneumoperitoneum, but no evidence of visceral pathology was detected intraoperatively.