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[Spontaneous pneumoperitoneum in scleroderma].

F Bloch, J Leport, L Mallet

Gastroenterologie Clinique Et Biologique

|June 1, 1984

Summary

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Spontaneous pneumoperitoneum in systemic sclerosis can occur without bowel perforation. This complication, often linked to gastrointestinal issues, carries a poor prognosis and may not require surgery.

Area of Science:

Gastroenterology
Rheumatology
Radiology

Background:

Progressive systemic sclerosis (PSS) frequently involves the gastrointestinal tract, potentially leading to complications like pseudoileus.
Pneumoperitoneum, the presence of air in the abdominal cavity, is typically associated with bowel perforation.

Observation:

Two cases of women with PSS presenting with pseudoileus and asymptomatic pneumoperitoneum are described.
The first case showed pneumoperitoneum with pneumatosis cystoides intestinalis, persisting for 3 years.
The second case's pneumoperitoneum resolved with medical management of intestinal ileus.

Findings:

Neither case demonstrated evidence of digestive perforation during diagnostic evaluation or autopsy.
Surgery in the first case revealed no perforation or obstruction, despite initial presentation suggestive of obstruction.

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Autopsy in the second case showed bowel distention but no perforation.

Implications:

Pneumoperitoneum in PSS can occur independently of bowel perforation, challenging typical diagnostic assumptions.
The findings suggest that surgical intervention for pneumoperitoneum in PSS may be unnecessary and potentially harmful.
This complication appears to be associated with a significantly poor prognosis in patients with progressive systemic sclerosis.