Spontaneous pneumoperitoneum in pediatric patients: A case series

• Pneumoperitoneum may not always be an ominous sign in the pediatric population.
• Cases of non-surgical pneumoperitoneum in the pediatric population are scarce.
• The clinical picture of a patient should be the primary determinant of management.
• Conservative measures can be used in pediatrics with isolated pneumoperitoneum.
• If the diagnosis is still unclear, clinical correlation should take precedence.

IntroductionPneumoperitoneum frequently results in emergent surgery because it typically indicates an abdominal viscus perforation. However, this may not always be the case. There have been few recent reports in the pediatric population that document cases of pneumoperitoneum which could be considered for non-surgical management.Presentation of caseThis case series presents three different instances of pediatric patients with radiographic evidence of pneumoperitoneum who were subsequently found to have no perforated viscus following surgical intervention.ConclusionWe recommend that in the absence of peritoneal signs, fever, leukocytosis, significant abdominal pain, distension, or clinical deterioration, non-operative management be considered in pediatric patients with radiographic signs of pneumoperitoneum.