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[Pneumoperitoneum in polytraumatized patients without perforated hollow viscera]
Juan Antonio Asanza-Llorente1, María Carmen Quesada-Peinado, Juan Díaz-Oller
1Servicio de Cirugía General, Hospital San Agustín, Linares, Jaén, España. juannito@telefonica.net
Cirugia Espanola
|December 7, 2007
Summary
Pneumoperitoneum after blunt trauma is hard to diagnose. Gas in the abdomen may not mean bowel perforation, especially with chest trauma, suggesting conservative treatment might be an option.
Area of Science:
- Trauma surgery
- Diagnostic imaging
Background:
- Bowel and mesenteric injuries from blunt abdominal trauma are rare and challenging to diagnose.
- Pneumoperitoneum on computed tomography (CT) is a key indicator but lacks specificity.
Observation:
- Gas can enter the peritoneal cavity via diaphragmatic defects in cases of associated blunt chest trauma.
- Two cases presented with pneumoperitoneum following combined blunt chest and abdominal trauma.
Findings:
- Laparotomy revealed no bowel perforation in either reported case.
- The presence of pneumoperitoneum in these specific scenarios did not necessitate surgical intervention.
Implications:
- Conservative management may be appropriate for select patients with pneumoperitoneum secondary to blunt chest and abdominal trauma.
- Rethinking the immediate surgical approach for pneumoperitoneum in the context of associated blunt chest trauma is warranted.
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