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Related Experiment Videos

Recurrent pneumoperitoneum following vaginal insufflation.

J Varon1, M D Laufer, G L Sternbach

  • 1Department of Medicine, Stanford University Medical Center, CA 94305.

The American Journal of Emergency Medicine
|September 1, 1991
PubMed
Summary

A 24-year-old woman experienced severe abdominal pain due to pneumoperitoneum caused by sexual activity. A detailed sexual history is crucial to diagnose this rare condition and avoid unnecessary surgeries.

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Area of Science:

  • Medicine
  • Gastroenterology
  • Gynecology

Background:

  • Pneumoperitoneum, the presence of air in the abdominal cavity, is typically associated with gastrointestinal perforation or trauma.
  • Diagnosing the cause of pneumoperitoneum is critical to guide appropriate medical or surgical management.

Observation:

  • A 24-year-old nulligravida woman presented with severe abdominal pain and radiographic evidence of pneumoperitoneum.
  • She had a history of two prior exploratory surgeries for similar symptoms without a diagnosis.
  • A detailed sexual history revealed that her partner had forcefully introduced air into her vagina prior to each episode.

Findings:

  • The patient's pneumoperitoneum was directly linked to vaginal barotrauma from sexual activity.
  • This case highlights a rare cause of pneumoperitoneum, previously reported in multigravida patients.

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Implications:

  • A thorough sexual history is essential in cases of unexplained pneumoperitoneum, especially in the absence of typical gastrointestinal symptoms or trauma.
  • This diagnostic approach can prevent misdiagnosis and unnecessary surgical interventions, such as laparotomies.
  • Recognizing sexual activity as a potential cause of pneumoperitoneum is important for gynecologists and emergency physicians.