Pneumoperitoneum Following Perineal Air Insufflation can be Managed Conservatively
Mohammad Alabdallat1, Ammar Almadani1, Murad Alahmad1
1Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar.
European Journal of Case Reports in Internal Medicine
|April 16, 2026
Summary
Pneumoperitoneum from rectal air insufflation can be a surgical emergency, but this case shows conservative management is possible. Differentiating traumatic from perforated causes prevents unnecessary surgery.
Area of Science:
- Medical Imaging
- Gastroenterology
- Trauma Surgery
Background:
- Pneumoperitoneum typically indicates a perforated viscus, often requiring emergency surgery.
- A rare cause is perianal air insufflation, leading to free air without perforation.
- Distinguishing these causes is crucial for appropriate patient management.
Purpose of the Study:
- To present a case of pneumoperitoneum due to perianal air insufflation managed conservatively.
- To highlight the importance of differentiating surgical from non-surgical pneumoperitoneum.
- To emphasize conservative treatment protocols for non-perforated cases.
Main Methods:
- Case report of a patient with pneumoperitoneum following perianal air insufflation.
- Clinical and radiological assessment to exclude visceral perforation.
- Conservative management strategy implementation.
Main Results:
- The patient presented with pneumoperitoneum and subcutaneous emphysema after air insufflation.
- Radiological evaluation confirmed intra-abdominal free air but no signs of perforation.
- Conservative management was successful, avoiding surgical intervention.
Conclusions:
- Perianal air insufflation can cause pneumoperitoneum without visceral perforation.
- Thorough clinical and radiological assessment is key to identifying non-surgical cases.
- Conservative management is a viable option, preventing unnecessary laparotomy and associated risks.
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