Diagnosis and treatment of pediatric benign pneumoperitoneum: A case report series of 9 patients
Benign pneumoperitoneum (BPPT) is defined as asymptomatic free intraabdominal air or as pneumoperitoneum without peritonitis. Symptomatic free air requires surgical anagement, but management of asymptomatic pneumoperitoneum is controversial. In this study, we investigate the diagnosis and treatment...
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| Veröffentlicht in: | Medicine (Baltimore) 2017-01, Vol.96 (2), p.e5814-e5814 |
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| creator | Duan, Shou-Xing Sun, Zong-Bo Wang, Guang-Huan Zhong, Jun Ou, Wen-Hui Fu, Ma-Xian Wang, Fu-Sheng Ma, Shu-Hua Li, Jian-Hong |
| description | Benign pneumoperitoneum (BPPT) is defined as asymptomatic free intraabdominal air or as pneumoperitoneum without peritonitis. Symptomatic free air requires surgical anagement, but management of asymptomatic pneumoperitoneum is controversial. In this study, we investigate the diagnosis and treatment of BPPT in children.
The clinical data of 9 pediatric patients with BPPT who were admitted to our hospital from January 2000 to January 2015 were retrospectively analyzed to summarize the diagnosis and treatment. Overall, 9 cases were included with 8 males and 1 female, aged from 4 days to 4 years. Among them there were 6 newborns (including 1 premature infant). Patients were all admitted to hospital with the major clinical symptom of abdominal distension, including 2 cases accompanied by tachypnea, 2 cases with vomiting, 1 case with diarrhea, and 2 cases with fever. No previous constipation or obstructive defecation existed. Six newborns had meconium defecation within 24 hours after birth. Physical examination revealed all patients with relaxed abdominal wall except 1 patient with abdominal distension had slight muscle stiffness and hyperactive bowel sounds. Abdominal X-ray suggested free air under the diaphragm in all cases.
All patients except for one case of laparotomy were conservatively treated and cured with fasting, infection prevention, rehydration, abdominocentesis, and close observation. Nine cases of patients were all discharged with no death occurrence. After discharge follow-up of 7 months to 6 years was conducted. There was no recurrence of similar symptoms, and children were in good growth and development.
The diagnosis of BPPT mainly relies on clinical symptoms in patient, careful abdominal examination, abdominal X-ray combined with abdominocentesis, and the exclusion of gastrointestinal perforation for confirmation. Conservative treatment can cure the disease. Attention should be paid to distinguish with surgical pneumoperitoneum to avoid unnecessary surgical exploration. |
| doi_str_mv | 10.1097/MD.0000000000005814 |
| format | Article |
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The clinical data of 9 pediatric patients with BPPT who were admitted to our hospital from January 2000 to January 2015 were retrospectively analyzed to summarize the diagnosis and treatment. Overall, 9 cases were included with 8 males and 1 female, aged from 4 days to 4 years. Among them there were 6 newborns (including 1 premature infant). Patients were all admitted to hospital with the major clinical symptom of abdominal distension, including 2 cases accompanied by tachypnea, 2 cases with vomiting, 1 case with diarrhea, and 2 cases with fever. No previous constipation or obstructive defecation existed. Six newborns had meconium defecation within 24 hours after birth. Physical examination revealed all patients with relaxed abdominal wall except 1 patient with abdominal distension had slight muscle stiffness and hyperactive bowel sounds. Abdominal X-ray suggested free air under the diaphragm in all cases.
All patients except for one case of laparotomy were conservatively treated and cured with fasting, infection prevention, rehydration, abdominocentesis, and close observation. Nine cases of patients were all discharged with no death occurrence. After discharge follow-up of 7 months to 6 years was conducted. There was no recurrence of similar symptoms, and children were in good growth and development.
The diagnosis of BPPT mainly relies on clinical symptoms in patient, careful abdominal examination, abdominal X-ray combined with abdominocentesis, and the exclusion of gastrointestinal perforation for confirmation. Conservative treatment can cure the disease. Attention should be paid to distinguish with surgical pneumoperitoneum to avoid unnecessary surgical exploration.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000005814</identifier><identifier>PMID: 28079808</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health</publisher><subject>Child, Preschool ; Clinical Case Report ; Diagnosis, Differential ; Female ; Humans ; Infant ; Infant, Newborn ; Laparotomy ; Male ; Physical Examination ; Pneumoperitoneum - diagnostic imaging ; Pneumoperitoneum - etiology ; Pneumoperitoneum - therapy ; Radiography, Abdominal ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Medicine (Baltimore), 2017-01, Vol.96 (2), p.e5814-e5814</ispartof><rights>Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c310t-c79c3b5482b16c599a2bba38cb5b2b1c9a23570be286006b6ca83e8f2a3b555c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266170/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266170/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28079808$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duan, Shou-Xing</creatorcontrib><creatorcontrib>Sun, Zong-Bo</creatorcontrib><creatorcontrib>Wang, Guang-Huan</creatorcontrib><creatorcontrib>Zhong, Jun</creatorcontrib><creatorcontrib>Ou, Wen-Hui</creatorcontrib><creatorcontrib>Fu, Ma-Xian</creatorcontrib><creatorcontrib>Wang, Fu-Sheng</creatorcontrib><creatorcontrib>Ma, Shu-Hua</creatorcontrib><creatorcontrib>Li, Jian-Hong</creatorcontrib><title>Diagnosis and treatment of pediatric benign pneumoperitoneum: A case report series of 9 patients</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Benign pneumoperitoneum (BPPT) is defined as asymptomatic free intraabdominal air or as pneumoperitoneum without peritonitis. Symptomatic free air requires surgical anagement, but management of asymptomatic pneumoperitoneum is controversial. In this study, we investigate the diagnosis and treatment of BPPT in children.
The clinical data of 9 pediatric patients with BPPT who were admitted to our hospital from January 2000 to January 2015 were retrospectively analyzed to summarize the diagnosis and treatment. Overall, 9 cases were included with 8 males and 1 female, aged from 4 days to 4 years. Among them there were 6 newborns (including 1 premature infant). Patients were all admitted to hospital with the major clinical symptom of abdominal distension, including 2 cases accompanied by tachypnea, 2 cases with vomiting, 1 case with diarrhea, and 2 cases with fever. No previous constipation or obstructive defecation existed. Six newborns had meconium defecation within 24 hours after birth. Physical examination revealed all patients with relaxed abdominal wall except 1 patient with abdominal distension had slight muscle stiffness and hyperactive bowel sounds. Abdominal X-ray suggested free air under the diaphragm in all cases.
All patients except for one case of laparotomy were conservatively treated and cured with fasting, infection prevention, rehydration, abdominocentesis, and close observation. Nine cases of patients were all discharged with no death occurrence. After discharge follow-up of 7 months to 6 years was conducted. There was no recurrence of similar symptoms, and children were in good growth and development.
The diagnosis of BPPT mainly relies on clinical symptoms in patient, careful abdominal examination, abdominal X-ray combined with abdominocentesis, and the exclusion of gastrointestinal perforation for confirmation. Conservative treatment can cure the disease. Attention should be paid to distinguish with surgical pneumoperitoneum to avoid unnecessary surgical exploration.</description><subject>Child, Preschool</subject><subject>Clinical Case Report</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Laparotomy</subject><subject>Male</subject><subject>Physical Examination</subject><subject>Pneumoperitoneum - diagnostic imaging</subject><subject>Pneumoperitoneum - etiology</subject><subject>Pneumoperitoneum - therapy</subject><subject>Radiography, Abdominal</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUUtLAzEQDqJoffwCQXL0sjWPzW7Wg1BaX6B40XNM0mmNdDdrkgr-e1NaizqXeX7fDPMhdErJkJKmvnicDMkvE5KWO2hABa8K0VTlLhoQwkRRN3V5gA5jfCeE8pqV--iASVI3ksgBep04Pe98dBHrbopTAJ1a6BL2M9zD1OkUnMUGOjfvcN_BsvU9BJf8KrzEI2x1BByg9yHhmDsQV9AG9zq5zBOP0d5MLyKcbPwRerm5fh7fFQ9Pt_fj0UNhOSWpsHVjuRGlZIZWVjSNZsZoLq0RJpdszrmoiQEmK0IqU1ktOcgZ0xklhOVH6GrN2y9NC1Obdwe9UH1wrQ5fymun_nY696bm_lMJVlW0JpngfEMQ_McSYlKtixYWC92BX0ZFZf4wEYzKPMrXozb4GAPMtmsoUStt1ONE_dcmo85-X7jF_IjBvwF96ou8</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Duan, Shou-Xing</creator><creator>Sun, Zong-Bo</creator><creator>Wang, Guang-Huan</creator><creator>Zhong, Jun</creator><creator>Ou, Wen-Hui</creator><creator>Fu, Ma-Xian</creator><creator>Wang, Fu-Sheng</creator><creator>Ma, Shu-Hua</creator><creator>Li, Jian-Hong</creator><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170101</creationdate><title>Diagnosis and treatment of pediatric benign pneumoperitoneum: A case report series of 9 patients</title><author>Duan, Shou-Xing ; Sun, Zong-Bo ; Wang, Guang-Huan ; Zhong, Jun ; Ou, Wen-Hui ; Fu, Ma-Xian ; Wang, Fu-Sheng ; Ma, Shu-Hua ; Li, Jian-Hong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c310t-c79c3b5482b16c599a2bba38cb5b2b1c9a23570be286006b6ca83e8f2a3b555c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Child, Preschool</topic><topic>Clinical Case Report</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Laparotomy</topic><topic>Male</topic><topic>Physical Examination</topic><topic>Pneumoperitoneum - diagnostic imaging</topic><topic>Pneumoperitoneum - etiology</topic><topic>Pneumoperitoneum - therapy</topic><topic>Radiography, Abdominal</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duan, Shou-Xing</creatorcontrib><creatorcontrib>Sun, Zong-Bo</creatorcontrib><creatorcontrib>Wang, Guang-Huan</creatorcontrib><creatorcontrib>Zhong, Jun</creatorcontrib><creatorcontrib>Ou, Wen-Hui</creatorcontrib><creatorcontrib>Fu, Ma-Xian</creatorcontrib><creatorcontrib>Wang, Fu-Sheng</creatorcontrib><creatorcontrib>Ma, Shu-Hua</creatorcontrib><creatorcontrib>Li, Jian-Hong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duan, Shou-Xing</au><au>Sun, Zong-Bo</au><au>Wang, Guang-Huan</au><au>Zhong, Jun</au><au>Ou, Wen-Hui</au><au>Fu, Ma-Xian</au><au>Wang, Fu-Sheng</au><au>Ma, Shu-Hua</au><au>Li, Jian-Hong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis and treatment of pediatric benign pneumoperitoneum: A case report series of 9 patients</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>96</volume><issue>2</issue><spage>e5814</spage><epage>e5814</epage><pages>e5814-e5814</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Benign pneumoperitoneum (BPPT) is defined as asymptomatic free intraabdominal air or as pneumoperitoneum without peritonitis. Symptomatic free air requires surgical anagement, but management of asymptomatic pneumoperitoneum is controversial. In this study, we investigate the diagnosis and treatment of BPPT in children.
The clinical data of 9 pediatric patients with BPPT who were admitted to our hospital from January 2000 to January 2015 were retrospectively analyzed to summarize the diagnosis and treatment. Overall, 9 cases were included with 8 males and 1 female, aged from 4 days to 4 years. Among them there were 6 newborns (including 1 premature infant). Patients were all admitted to hospital with the major clinical symptom of abdominal distension, including 2 cases accompanied by tachypnea, 2 cases with vomiting, 1 case with diarrhea, and 2 cases with fever. No previous constipation or obstructive defecation existed. Six newborns had meconium defecation within 24 hours after birth. Physical examination revealed all patients with relaxed abdominal wall except 1 patient with abdominal distension had slight muscle stiffness and hyperactive bowel sounds. Abdominal X-ray suggested free air under the diaphragm in all cases.
All patients except for one case of laparotomy were conservatively treated and cured with fasting, infection prevention, rehydration, abdominocentesis, and close observation. Nine cases of patients were all discharged with no death occurrence. After discharge follow-up of 7 months to 6 years was conducted. There was no recurrence of similar symptoms, and children were in good growth and development.
The diagnosis of BPPT mainly relies on clinical symptoms in patient, careful abdominal examination, abdominal X-ray combined with abdominocentesis, and the exclusion of gastrointestinal perforation for confirmation. Conservative treatment can cure the disease. Attention should be paid to distinguish with surgical pneumoperitoneum to avoid unnecessary surgical exploration.</abstract><cop>United States</cop><pub>Wolters Kluwer Health</pub><pmid>28079808</pmid><doi>10.1097/MD.0000000000005814</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Medicine (Baltimore), 2017-01, Vol.96 (2), p.e5814-e5814 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Wolters Kluwer Open Health; IngentaConnect Free/Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Child, Preschool Clinical Case Report Diagnosis, Differential Female Humans Infant Infant, Newborn Laparotomy Male Physical Examination Pneumoperitoneum - diagnostic imaging Pneumoperitoneum - etiology Pneumoperitoneum - therapy Radiography, Abdominal Retrospective Studies Treatment Outcome |
| title | Diagnosis and treatment of pediatric benign pneumoperitoneum: A case report series of 9 patients |
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