Kosin Med J.  2024 Dec;39(4):294-298. 10.7180/kmj.24.115.

Idiopathic pneumoperitoneum diagnosed and treated differently in preterm infants: two case reports

• Park SJ
• Park KH

• KMID: 2562814
• DOI: http://doi.org/10.7180/kmj.24.115

Abstract

Pneumoperitoneum that develops in the absence of a perforated abdominal viscus and does not require laparotomy is considered to be idiopathic. Differentiating between idiopathic pneumoperitoneum and highly lethal perforation due to necrotizing enterocolitis in preterm infants is important. Herein, we report two cases of idiopathic pneumoperitoneum in preterm infants who underwent exploratory laparotomy and conservative treatment, respectively. The first patient was born at 32+5 weeks of gestation and developed pneumoperitoneum on day 7 of life. The patient underwent exploratory laparotomy and was diagnosed with idiopathic pneumoperitoneum after surgery. The second patient was born at 30 weeks of gestation. He developed pneumoperitoneum on the eighth day of life. Idiopathic pneumoperitoneum was suspected, and the patient was treated conservatively without laparotomy. Based on our awareness and experience of the first case of idiopathic pneumoperitoneum, we were able to treat the second patient conservatively. These cases will be helpful for diagnosing and treating pneumoperitoneum in preterm infants.

Keyword

Case reports; Infant, premature; Pneumoperitoneum

Figure

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  Fig. 1. Plain abdominal X-ray showing free peritoneal air occupying the entire abdomen in patient 1. (A) Supine view. (B) Lateral view.

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  Fig. 2. Plain abdominal X-ray showing free air in patient 2. (A, B) Day of pneumoperitoneum onset. (C) Three days after onset, a lateral abdominal X-ray showed decreased pneumoperitoneum. (D) Four days after onset, pneumoperitoneum worsened after feeding. (E) Eight days after onset, the free air had nearly resolved.

Reference

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