To report a case of pneumoperitoneum associated with jejunal diverticulosis.Design:
Case report and review of the literature.Patient:
An 80-year-old man presented with free air under the diaphragm, diagnosed on a routine chest X-ray. Clinical history revealed abdominal discomfort and weight loss during the previous year. There were no signs of peritonitis. Enteroclysis showed jejunal diverticulosis. Glucose/hydrogen breath test was pathological.Intervention:
After antibiotic treatment, the patient improved, but the pneumoperitoneum persisted. Antibiotic treatment had to be stopped because of side effects. The patient remains well without further treatment.Outcome:
Since 1956, 16 patients have been reported with pneumoperitoneum associated with jejunal diverticulosis without anatomical perforation. Bacterial gas production may be an important pathophysiological mechanism.Conclusion:
When pneumoperitoneum without peritonitis is diagnosed, jejunal diverticulosis should be considered as a possible cause. Awareness of this condition may prevent unnecessary surgical intervention.