Pneumoperitoneum

Pneumoperitoneum or free intraperitoneal air in the neonatal period is usually the result of a hollow viscous perforation. In healthy neonates, the perforation is usually iatrogenic, secondary to the insertion of a tube or a rectal thermometer (Fig. 1.43). Necrotiz ing enterocolitis is the most common cause of pneumoperitoneum in the neonatal intensive care unit. Intestinal atresia is also an important cause, the perforation usually occurring in the dilated loops above the atresia. Ruptured or perforated Meckel, sigmoid, and jejunal diverticula, toxic megacolon, and idio-pathic gastric perforation in premature infants are also common causes of pneumoperitoneum in the

Massive Insertion

Fig. 1.43a-d. Pneumoperitoneum. a Massive pneumoperitoneum complicating the insertion of a rectal tube. b Pneumoperitoneum (arrows) in a newborn with ileal atresia. c Massive pneumothorax, pneumomediastinum and pneumoperitoneum (arrows) in a patient that had been supported by mechanical ventilation. d Neonate with abdominal distension following the insertion of a rectal thermometer. A supine radiograph shows a lucency occupying the entire abdominal cavity (arrows) and the falciform ligament outlined by air

Fig. 1.43a-d. Pneumoperitoneum. a Massive pneumoperitoneum complicating the insertion of a rectal tube. b Pneumoperitoneum (arrows) in a newborn with ileal atresia. c Massive pneumothorax, pneumomediastinum and pneumoperitoneum (arrows) in a patient that had been supported by mechanical ventilation. d Neonate with abdominal distension following the insertion of a rectal thermometer. A supine radiograph shows a lucency occupying the entire abdominal cavity (arrows) and the falciform ligament outlined by air neonatal period. At times, free intraperitoneal air may be seen in neonates supported by mechanical ventilation. It occurs following a pathway through the normal diaphragmatic foramina. There is no perforation of the gastrointestinal tract in these cases.

differ with the age group, thus simplifying the differential diagnosis (Table 1.1).

The role of diagnostic imaging is to determine whether the acute abdominal pain is due to a surgically or medically treated disease and, if possible, to diagnose the exact nature of the ailment. Since

Table 1.1. Causes of acute abdomen in children

Was this article helpful?

0 0
51 Tips for Dealing with Endometriosis

51 Tips for Dealing with Endometriosis

Do you have Endometriosis? Do you think you do, but aren’t sure? Are you having a hard time learning to cope? 51 Tips for Dealing with Endometriosis can help.

Get My Free Ebook


Post a comment