Pneumoperitoneum due to peritoneovaginal fistula following hysterectomy

A patient with pneumoperitoneum that developed due to peritoneovaginal fistula following hysterectomy is presented. In addition, we have reviewed the literature and formulated guidelines for the management of this problem. Most patients present following sexual intercourse and in many cases the fistula can be diagnosed radiographically. Laparotomy may be avoided if the cause of the fistula is suspected. Surgical closure of the fistula may be unnecessary since spontaneous closure occurs frequently.