Pneumoperitoneum is the presence of air in the abdominal cavity. There are a number of reasons for a person to develop air inside the abdominal cavity and it is important to determine why the air is present when pneumoperitoneum is identified on a medical imaging study. It can be a sign of a medical emergency that requires prompt surgical intervention in order to prevent future complications and other medical issues. It may also be a normal circumstance that does not require aggressive treatment.
Patients with this condition may develop symptoms like abdominal pain and tenderness in addition to other symptoms related to the cause of the air buildup. Relatively small amounts of air may be present in the abdomen. Medical imaging studies such as CT scans are used to visualize the abdomen and modern imaging equipment can identify very small pockets of air. The shape, size, and location of the air pocket can provide important diagnostic clues.
A serious potential cause of air in the abdominal cavity is a perforation of the bowel or another organ, as may occur when an ulcer or abscess ruptures. Infections with bacteria that generate gas as a byproduct can also cause the condition. Sometimes air or gas enters through the female reproductive tract or as a consequence of constipation. It can also be iatrogenic, meaning that it is caused by a surgical procedure or other activity.
In fact, during laparoscopy, a procedure where tools are inserted into the abdomen through small incisions to conduct surgery, air is introduced deliberately. The abdomen is inflated with gas in order to make the surgical field clearer and easier to see. The gas is expelled after surgery but it is usually not completely removed, and the patient may have pneumoperitoneum for several weeks after the surgery until the gas deposit is dispersed by the body.
When a patient has pneumoperitoneum, the first step in treatment is finding out why, in order to develop an appropriate treatment approach. This may require additional diagnostic testing along with a patient interview. In some cases, conservative treatment is the most sensible course of action, with a doctor taking a wait and see approach to see if the patient's body is able to eliminate the gas on its own. If the pneumoperitoneum is a complication of an infection or rupture, surgery to correct the problem is required, preferably as quickly as possible. Perforations and infections can rapidly lead to life threatening medical emergencies.