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Pneumoperitoneum caused by spontaneous bacterial peritonitis: a case report
1Division of General Surgery, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|November 1, 1994
Summary
Spontaneous bacterial peritonitis (SBP) rarely causes pneumoperitoneum. This case highlights SBP diagnosis in a patient presenting with pneumoperitoneum, emphasizing prompt antibiotic treatment for gas-forming bacteria.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Case Reports
Background:
- Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with ascites.
- Pneumoperitoneum, the presence of air in the abdominal cavity, is an uncommon presentation of SBP.
Observation:
- A 65-year-old male with a history of peptic ulcer presented with acute abdominal pain and subphrenic free air.
- Despite initial suspicion of perforated peptic ulcer, laparotomy revealed no perforation but 200 ml of purulent ascites.
Findings:
- Ascites culture identified E. coli, B. fragilis, and P. aeruginosa, confirming SBP.
- The patient had no other detected underlying diseases or compromised immunity.
Implications:
- This case underscores the rare presentation of SBP as pneumoperitoneum.
- Early administration of antibiotics effective against gas-forming bacteria is crucial, even before culture results are available.