Pneumoperitoneum in a patient with pneumothorax and blunt neck trauma

• Free air in the abdomen after blunt traumatic neck injury is very rare.
• If pneumoperitoneum is suspected, exploratory laparotomy should be performed to rule out intraabdominal injury.
• Conservative management for pneumoperitoneum in the absence of viscus perforation is still a safe option in carefully selected cases.

INTRODUCTIONBlunt trauma as a cause of pneumoperitoneum is less frequent and its occurrence without a ruptured viscus is rarely seen.PRESENTATION OF CASEWe report a case of blunt neck trauma in which a motorcycle rider hit a fixed object causing severe laryngotracheal injury. The patient developed pneumothorax bilaterally and had pneumoperitoneum despite no injury to the internal viscus. Bilateral chest tube drainage and abdominal exploratory laparotomy was performed.CONCLUSIONFree air in the abdomen after blunt traumatic neck injury is very rare. If pneumoperitoneum is suspected in the presence of pneumothorax, exploratory laparotomy should be performed to rule out intraabdominal injury. As, there is no consensus for this plan yet, further prospective studies are warrant. Conservative management for pneumoperitoneum in the absence of viscus perforation is still a safe option in carefully selected cases.