Spontaneous pneumoperitoneum associated with jejunal diverticulosis

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To report a case of pneumoperitoneum associated with jejunal diverticulosis.


Case report and review of the literature.


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.


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.


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.


When pneumoperitoneum without peritonitis is diagnosed, jejunal diverticulosis should be considered as a possible cause. Awareness of this condition may prevent unnecessary surgical intervention.

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