Pneumoperitoneum associated with pneumothorax: a surgical dilemma in the post-traumatic patient

Two patients with pneumoperitoneum associated with post-traumatic pneumothorax are described. The role of artificial respiration in the production of pneumoperitoneum is descussed. This association presents a curious diagnostic dilemma. If the diagnosis of perforated hollow viscus can be eliminated with considerable certainty, then conservative management with careful observation and monitoring may avoid unnecessary surgery, so long as other causes of pneumoperitoneum have been ruled out.