PNEUMOPERITONEUM usually presents as a surgical emergency owing to perforation of a hollow viscus. Closure of the perforation in the stomach, duodenum, or colon must be accomplished immediately to halt peritoneal contamination. Often celiotomy fails to disclose a perforation site. In these cases, the origin of air has been ascribed to a small perforated duodenal ulcer, a minute leak from a colon diverticulum, a rupture of an emphysematous bleb, or an insufflation of air via the female genital tract in association with postpartum exercises, douching, and even pelvic examination.1 Oral-genital sex, normal daily exercises, salpingitis, and prolapsed fallopian tube have also been reported in conjunction with pneumoperitoneum.2 The following case is unusual, as the pneumoperitoneum occurred one year after hysterectomy.
Report of a Case
A 34-year-old woman, gravida 3, para 3, came to the emergency room complaining of severe abdominal pain that radiated to her left shoulder when