Tension pneumoperitoneum: case report and review of the literature

Tension pneumoperitoneum in an 81-year-old man resulted from the perforation of an ulcer on the posterior aspect of the first stage of the duodenum into the lesser sac. This condition, though rare, should be considered in the differential diagnosis of the massively distended abdomen. A number of different causes of this condition have been reported, most of which are associated with various diagnostic and therapeutic procedures. Treatment is early laparotomy.