[Pneumoperitoneum without perforation]

Usually, pneumoperitoneum is due to perforation of a hollow abdominal organ. In the absence of peritoneal symptoms, pneumoperitoneum may be due to other causes. Two patients with pneumoperitoneum without perforation were treated in our department. A 41-year-old female patient was admitted to our hospital with abdominal pain for 12 hours, without vomiting. On abdominal examination fullness of the liver was absent, the abdomen was not distended and there were no signs of peritoneal irritation. The roentgenogram showed free air under the diaphragm. Laparotomy was performed because of the abdominal complaints. No perforation could be found. A 70-year-old female patient was admitted to the hospital because of mild abdominal pain. For a week she had a severe attack of coughing due to bronchitis. Big capacity of air had been blown in the stomach without abnormalities in the roentgenologic examination. The treatment was conservative. Both patients left the hospital in good health. More knowledge of the less frequent causes of pneumoperitoneun without perforation can possibly contribute to to refraining from exploratory laparotomy in these cases.