Pneumoperitoneum: A review of nonsurgical causes

Critical Care Medicine

Volumn 28, Issue 7, 2000, Pages 2638-2644

  Mularski, Richard A ^a   Sippel, Jeffrey M ^a   Osborne, Molly L ^a  

^a OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

Author keywords

Barotrauma; Benign; Complications; Diaphagmatic defects; Free air; Gynecological; Iatrogenic; Laparoscopy; Laparotomy; Mechanical ventilation; Nonsurgical; Pneumat osis; Pneumoperitoneum; Spontaneous

Indexed keywords

ARTIFICIAL VENTILATION; CONSERVATIVE TREATMENT; GASTROINTESTINAL ENDOSCOPY; HUMAN; PNEUMOPERITONEUM; PNEUMOTHORAX; PREVALENCE; PRIORITY JOURNAL; RESUSCITATION; REVIEW;

EID: 0033865577     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/00003246-200007000-00078     Document Type: Review

References (153)

1. 1. Sabiston DC: Textbook of Surgery. 14th Edition. Philadelphia, PA, Saunders, 1991
2. 2. McGlone FB, Vivion CG, Meir L: Spontaneous pneumoperitoneum. Gastroenterology 1966; 51:393-398
3. 3. Roh JJ, Thompson JS, Harned RK, et al: Value of pneumoperitoneum in the diagnosis of visceral perforation. Am J Surg 1983; 146:830-833
4. 4. Winek TG, Mosely HS, Grout G, et al: Pneumoperitoneum and its association with ruptured abdominal viscus. Arch Surg 1988; 123:709-712
5. 5. Mularski RA, Ciccolo ML, Rappaport WD: Nonsurgical causes of pneumoperitoneum. West J Med 1999; 170:41-46
6. 6. Baker SR: The Abdominal Plain Film. East Norwalk, CT, Appleton and Lange, 1990
7. 7. Mokrohisky JF: Pseudopneumoperitoneum, simulated free air in the peritoneal cavity. Am J Roentgenol 1958; 79:293-300
8. 8. Paine JR, Rigler LG: Pneumoperitoneum in perforations of the gastrointestinal tract. Surgery 1938; 3:351-369
9. 9. Chandler JG, Berk RN, Golden GT: Misleading pneumoperitoneum. Surg Gynecol Obstet 1977; 144:163-174
10. 10. Cho KC, Baker SR: Extraluminal air. Diagnosis and significance. Radiol Clin North Am 1994; 32:829-844
11. 11. Schauer PR, Page CP, Ghiatas AA, et al: Incidence and significance of subdiaphragmatic air following laparoscopic cholecystectomy. Am Surg 1997; 63:132-136
12. 12. Kiefer T, Schenk U, Weber J, et al: Incidence and significance of pneumoperitoneum in continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1993; 22:30-35
13. 13. Chang JJ, Yeun JY, Hasbargen JA: Pneumoperitoneum in peritoneal dialysis patients. Am J Kidney Dis 1995; 25:297-301
14. 14. Lee FT Jr, Leahy-Gross KM, Hammond TG, et al: Pneumoperitoneum in peritoneal dialysis patients: Significance of diagnosis by CT. J Comput Assist Tomogr 1994; 18: 439-442
15. 15. Gottfried EB, Plumser AB, Clair MR: Pneumoperitoneum following percutaneous endoscopic gastrostomy: A prospective study. Gastrointest Endosc 1986; 32:397-399
16. 16. Pidala MJ, Slezak FA, Porter JA: Pneumoperitoneum following percutaneous endoscopic gastrostomy: Does the timing of panendoscopy matter? Surg Endosc 1992; 6:128-129
17. 17. Ecker MD, Goldstein M, Hoexter B, et al: Benign pneumoperitoneum after fiberoptic colonoscopy: A prospective study of 100 patients. Gastroenterology 1977; 73:226-230
18. 18. Carpio G, Albu E, Gumbs MA, et al: Management of colonic perforation after colonoscopy: Report of three cases. Dis Colon Rectum 1989; 32:624-626
19. 19. Damore LJ, Rantis PC, Vernava AM, et al: Colonoscopic perforations: Etiology, diagnosis, and management. Dis Colon Rectum 1996; 39:1308-1314
20. 20. Wakeen MJ, Zimmerman SW, Bidwell D: Viscus perforation in peritoneal dialysis patients: Diagnosis and outcome. Perit Dial Int 1994; 14:371-377
21. 21. Hamilton P, Rizoli S, McLellan B, et al: Significance of intra-abdominal extraluminal air detected by CT scan in blunt abdominal trauma. J Trauma 1995; 39:331-333
22. 22. The HIFI Study Group. High-frequency oscillatory ventilation compared with conventional mechanical ventilation in the treatment of respiratory failure in preterm infants. N Engl J Med 1989; 320:88-93
23. 23. Rosenfeld DL, Cordell CE, Jadeja N: Retrocardiac pneumomediastinum: Radiographic finding and clinical implications. Pediatrics 1990; 85:92-97
24. 24. Jones MT, Menkis AH, Kostuk WJ, et al: Management of general surgical problems after cardiac transplantation. Can J Surg 1988; 31:259-261, 263
25. 25. Nielsen KT, Lund L, Larsen KP, et al: Duration of postoperative pneumoperitoneum Eur J Surg 1997; 163:501-503 [published erratum appears in Eur J Surg 1997; 163: 880]
26. 26. Stapakis JC, Thickman D: Diagnosis of pneumoperitoneum: Abdominal CT vs. upright chest film. J Comput Assist Tomogr 1992; 16:713-716
27. 27. Earls JP, Dachman AH, Colon E, et al: Prevalence and duration of postoperative pneumoperitoneum: Sensitivity of CT vs left lateral decubitus radiography. AJR Am J Roentgenol 1993; 161:781-785
28. 28. Bryant LR, Wolf JF, Kloecker RJ: A study of the factors affecting the incidence and duration of post-operative pneumoperitoneum. Surg Gynecol Obstet 1963; 117: 145-150
29. 29. Silvis S, Nebel O, Rogers G: Results of 1974 American Society for Gastrointestinal Endoscopy survey. JAMA 1976; 235:928-930
30. 30. Taylor R, Weakley F, Sullivan B: Non-operative management of colonoscopic perforation with pneumoperitoneum. Gastrointest Endosc 1978; 24:124-125
31. 31. Nitvatvongs S: Complication of colonoscopic polypectomy: An experience with 1555 polypectomies. Dis Colon Rectum 1986; 29:825-830
32. 32. de Magalhaes-Silverman M, Simpson J, Ball E: Pneumoperitoneum without peritonitis after allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 1998; 21:1153-1154
33. 33. Day DL, Ramsay NK, Letourneau JG: Pneumatosis intestinalis after bone marrow transplantation. AJR Am J Roentgenol 1988; 151:85-87
34. 34. Brewaeys P, Ysebaert D, Hubens G, et al: Pneumatosis cystoides intestinalis. Conservative approach in non surgical pneumoperitoneum: A case report and literature review. Acta Chir Belg 1995; 95:195-198
35. 35. Kopp AF, Gronewaller E, Laniado M: Pneumatosis cystoides intestinalis with pneumoperitoneum and pneumoretroperitoneum following chemotherapy. Abdom Imaging 1997; 22:395-397
36. 36. Luks FI, Chung MA, Brandt ML, et al: Pneumatosis and pneumoperitoneum in chronic idiopathic intestinal pseudoobstruction. J Pediatr Surg 1991; 26:1384-1386
37. 37. Tak PP, Van Duinen CM, Bun P, et al: Pneumatosis cystoides intestinalis in intestinal pseudoobstruction: Resolution after therapy with metronidazole. Dig Dis Sci 1992; 37:949-954
38. 38. Pun YL, Russell DM, Taggart GJ, et al: Pneumatosis intestinalis and pneumoperitoneum complicating mixed connective tissue disease. Br J Rheumatol 1991; 30: 146-149
39. 39. Samach M, Brandt LJ, Bernstein LH: Spontaneous pneumoperitoneum with pneumatosis cystoides intestinalis in a patient with mixed connective tissue disease. Am J Gastroenterol 1978; 69:494-500
40. 40. van Leeuwen JC, Nossent JC: Pneumatosis intestinalis in mixed connective tissue disease. Neth J Med 1992; 40:299-304
41. 41. Wakamatsu M, Inada K, Tsutsumi Y: Mixed connective tissue disease complicated by pneumatosis cystoides intestinalis and malabsorption syndrome: Case report and literature review. Pathol Int 1995; 45:875-878
42. 42. Wilkinson MM: Small intestinal complications in progressive systemic sclerosis. Gastroenterol Nurs 1992; 15:50-53
43. 43. Lynn JT, Gossen G, Miller A, et al: Pneumatosis intestinalis in mixed connective tissue disease: Two case reports and literature review. Arthritis Rheum 1984; 27:1186-1189
44. 44. Pruitt RE, Tumminello W, Reveille JD: Pneumatosis cystoides intestinalis and benign pneumoperitoneum in a patient with antinuclear antibody negative systemic lupus erythematosus. J Rheumatol 1988; 15: 1575-1577
45. 45. Paira SO, Roverano S: Bilateral pneumothorax and mediastinal emphysema in systemic lupus erythematosis. Clin Rheumatol 1992; 11:571-573
46. 46. Oliveros MA, Herbst JJ, Lester PD, et al: Pneumatosis intestinalis in childhood dermatomyositis. Pediatrics 1973; 52:711-712
47. 47. Khouri MR, Levine MS, Dabezies M, et al: Benign pneumoperitoneum in a patient with celiac sprue. J Clin Gastroenterol 1989; 11:70-72
48. 48. Jorgensen A, Wille-Jorgensen P: Pneumatosis intestinales and pneumoperitoneum due to a solitary sigmoid diverticulum. Acta Chir Scand 1982; 148:625-626
49. 49. Faruqi SA, Joshi PN, Haley TO, et al: Asymptomatic recurrent spontaneous pneumoperitoneum. Am J Gastroenterol 1994; 89:2082-2084
50. 50. Ikard RW: Pneumatosis cystoides intestinalis following intestinal bypass. Am Surg 1977; 43:467-470
51. 51. Sicard GA, Vaughan R, Wise L: Pneumatosis cystoides intestinalis: An unusual complication of jejunoileal bypass. Surgery 1976; 79:480-484
52. 52. Hillman KM: Pneumoretroperitoneum. Anaesthesia 1983; 38:136-139
53. 53. DeMarino GB, Sumkin JH, Leventhal R, et al: Pneumatosis intestinalis and pneumoperitoneum after sclerotherapy. AJR Am J Roentgenol 1988; 151:953-954
54. 54. Wolloch Y, Dintsman M, Weiss A, et al: Pneumatosis cystoides intestinalis of adulthood. Arch Surg 1972; 105:723-726
55. 55. Andorsky RI: Pneumatosis cystoides intestinalis after organ transplantation. Am J Gastroenterol 1990; 85:189-194
56. 56. Broecker BH, Moore EE: Pneumoperitoneum due to pneumatosis cystoides intestinalis in idiopathic megacolon. JAMA 1977; 237:1963
57. 57. Tan AC, Schellekens PP, Wahab P, et al: Pneumatosis intestinalis, retroperitonealis, and thoracalis after argon plasma coagulation. Endoscopy 1995; 27:698-699
58. 58. Beilin B, Shulman DL, Weiss AT, et al: Pneumoperitoneum as the presenting sign of pulmonary barotrauma during artificial ventilation. Intensive Care Med 1986; 12: 49-51
59. 59. Craft TM, Chambers PH, Ward ME, et al: Two cases of barotrauma associated with transtracheal jet ventilation. Br J Anaesth 1990; 64:524-527
60. 60. du Plessis HJ, Ingram HJ: Pneumoperitoneum as a sign of pulmonary barotrauma during artificial ventilation. Intensive Care Med 1987; 13:213
61. 61. Egol A, Culpepper JA, Snyder JV: Barotrauma and hypotension resulting from jet ventilation in critically ill patients. Chest 1985; 88:98-102
62. 62. Gutkin Z, Iellin A, Meged S, et al: Spontaneous pneumoperitoneum without peritonitis. Int Surg 1992; 77:219-223
63. 63. Ilgren EB, Symchych PS, Redo SF: Pneumoperitoneum without ruptured viscus in the neonate: A case report and review of the literature. J Pediatr Surg 1977; 12:537-540
64. 64. Lopez Rodriguez A, Lopez Sanchez L, Julia JA: Pneumoperitoneum associated with manual ventilation using a bag-valve device. Acad Emerg Med 1995; 2:944
65. 65. Meislin HW, Iserson KV, Kaback KR, et al: Airway trauma. Emerg Med Clin North Am 1983; 1:295-312
66. 66. Ralston C, Clutton-Brock TH, Hutton P: Tension pneumoperitoneum. Intensive Care Med 1989; 15:532-533
67. 67. Siegel S: Case of the season: Pneumoperitoneum secondary to barotrauma. Semin Roentgenol 1994; 29:318-320
68. 68. Stringfield JT, Graham JP, Watts CM, et al: Pneumoperitoneum. A complication of mechanical ventilation. JAMA 1976; 235: 744-746
69. 69. Turner WW, Fry WJ: Pneumoperitoneum complicating mechanical ventilator therapy. Arch Surg 1977; 112:723-726
70. 70. van Gelder HM, Allen KB, Renz B, et al: Spontaneous pneumoperitoneum. A surgical dilemma. Am Surg 1991: 57:151-156
71. 71. Hansen TN, Gest AL: Oxygen toxicity and other ventilatory complications of treatment of infants with persistent pulmonary hypertension. Clin Perinatol 1984; 11: 653-672
72. 72. Winer-Muram HT, Rumbak MJ, Bain RS Jr: Tension pneumoperitoneum as a complication of barotrauma. Crit Care Med 1993; 21:941-943
73. 73. Rohlfing BM, Webb WR, Schlobohm RM: Ventilator-related extra-alveolar air in adults. Radiology 1976; 121:25-31
74. 74. Seltzer RA: Pneumoperitoneum following intermittent positive pressure breathing. West J Med 1977; 126:506-509
75. 75. Summers B: Pneumoperitoneum associated with artificial ventilation. BMJ 1979; 1:1528-1530
76. 76. Keidar S, Freud M, Rothfeld H, et al: Pneumoperitoneum after mechanical ventilation without pneumothorax or pneumomediastinum. Int Surg 1982; 67:275-276
77. 77. Evron S, Beyth Y, Samueloff A, et al: Pulmonary complications following endotracheal intubation for anesthesia in breech extraction. Intensive Care Med 1985; 11: 223-225
78. 78. Henry RE, Ali N, Banks T, et al: Pneumoperitoneum associated with mechanical ventilation. J Natl Med Assoc 1986; 78: 539-541
79. 79. Reiche-Fischel O, Helfrick JF: Intraoperative life-threatening emphysema associated with endotracheal intubation and air insufflation devices: Report of two cases. J Oral Maxillofac Surg 1995; 53:1103-1107
80. 80. Glauser FL, Barlett RH: Pneumoperitoneum in association with pneumothorax. Chest 1974; 66:536-540
81. 81. Chitchley LAH, Rowbottom S: Fatal tension Pneumoperitoneum with pneumothorax. Anaesth Intensive Care 1994; 11:298-299
82. 82. Safadi R, Sibirsky O, Ben Menahem N, et al: Pneumoperitoneum in an older patient. J Am Geriatr Soc 1995; 43:722-723
83. 83. Lee R, Zaman M, Bondi E, et al: A case of free air in the peritoneum. West J Med 1995; 163:387-388
84. 84. Hargarten KM, Aprahamian C, Mateer J: Pneumoperitoneum as a complication of cardiopulmonary resuscitation. Am J Emerg Med 1988; 6:358-361
85. 85. Parke TR: Unexplained pneumoperitoneum in association with basic cardiopulmonary resuscitation efforts. Resuscitation 1993; 26:177-181
86. 86. Rainer TH, Crawford R: Pre-hospital cardiopulmonary resuscitation and pneumoperitoneum. J Accid Emerg Med 1995; 12: 288-290
87. 87. George A, Tighe SQM: An unusual complication of cardiopulmonary resuscitation. Anaesthesia 1994; 49:742
88. 88. Krischer JP, Fine EG, Davis JH, et al: Complications of cardiac resuscitation. Chest 1987; 92:287-291
89. 89. Atcheson SG, Petersen GV, Fred HL: Ill-effects of cardiac resuscitation: Report of two unusual cases. Chest 1975; 67:615-616
90. 90. Fataar S, Morton P, Schulman A: Recurrent non-surgical pneumoperitoneum due to spontaneous pneumothorax. Br J Radiol 1981; 54:1100-1102
91. 91. Tamura K, Satoh Y, Ikoma A, et al: Pneumoperitoneum in a patient with lymphangiomyomatosis. Respiration 1991; 58: 211-213
92. 92. Furman WR, Wang KP, Summer WR, et al: Catamenial pneumothorax: Evaluation by fiberoptic pleuroscopy. Am Rev Respir Dis 1980; 121:137-140
93. 93. Vestal BK, Vestal RE: latrogenic pneumothorax: An unusual cause. JAMA 1976; 235: 1879-1880
94. 94. Egan M, Boutros A: Pneumoperitoneum following tension pneumothorax: Report of two cases. Crit Care Med 1975; 3:170-172
95. 95. Critchley LA, Rowbottom S: Fatal tension pneumoperitoneum with pneumothorax. Anaesth Intensive Care 1994; 22:298-299
96. 96. Barnhart GR, Brooks JW, Kellum JM: Pneumoperitoneum resulting from tracheal rupture following blunt chest trauma. J Trauma 1986; 26:486-488
97. 97. Nour S, Pereira NH, Mackinnon AE: Pneumoperitoneum from a ruptured bronchus in a child. Br J Surg 1993; 80:212
98. 98. Mitchell JB, Ward PM: The management of tracheal rupture using bilateral bronchial intubation. Anaesthesia 1993; 48:223-225
99. 99. Glanz S, Ravin CE, Deren MM: Benign pneumoperitoneum following median sternotomy incision. AJR Am J Roentgenol 1978; 131:267-269
100. 100. Oppenheim A, Pizov R, Pikarsky A, et al: Tension pneumoperitoneum after blast injury: Dramatic improvement in ventilatory and hemodynamic parameters after surgical decompression. J Trauma 1998; 44: 915-917
101. 101. Winfield AC: Pneumoperitoneum secondary to pneumocolon examination. South Med J 1982; 75:484-486
102. 102. Mirzayan R, Cepkinian V, Asensio JA: Subcutaneous emphysema, pneumomediastinum, pneumothorax, pneumopericardium, and pneumoperitoneum from rectal barotrauma. J Trauma 1996; 41:1073-1075
103. 103. Allison DJ, Fletcher DR, Gordon-Smith EC: Therapeutic arterial embolisation of the spleen: A new cause of free intraperitoneal gas. Clin Radiol 1981; 32:617-621
104. 104. Dachman AH, Newmark GM, Thistlethwaite JR Jr, et al: Imaging of pancreatic transplantation using portal venous and enteric exocrine drainage. AJR Am J Roentgenol 1998; 171:157-163
105. 105. Ulloa Ramirez SA, Ortiz Justiniano VN, Soler Candelaria E, et al: Gastric emphysema simulating perforated hollow viscus: Case report and review of literature. Bol Asoc Med P R 1997; 89:200-202
106. 106. Daly BD, Guthrie JA, Couse NF: Pneumoperitoneum without peritonitis. Postgrad Med J 1991; 67:999-1003
107. 107. Dodek SM, Friedman JM: Spontaneous pneumoperitoneum. Obstet Gynecol 1953; 1:689-698
108. 108. Cass LJ, Dow EC, Brooks JR: Pneumoperitoneum following pelvic examination. Am J Gastroenterol 1966; 45:209-211
109. 109. Christiansen WC, Danzl DP, McGee HJ: Pneumoperitoneum following vaginal insufflation and coitus. Ann Emerg Med 1980; 9:480-482
110. 110. Freeman RK: Pneumoperitoneum from oral-genital insufflation. Obstet Gynecol 1970; 36:162-164
111. 111. Gantt CB Jr, Daniel WW, Hallenbeck GA: Nonsurgical pneumoperitoneum. Am J Surg 1977; 134:411-414
112. 112. Gensburg RS, Wojcik WG, Mehta SD: Vaginally-induced pneumoperitoneum during pregnancy. Am J Radiology 1988; 150: 595-596
113. 113. Lozman H, Newman AJ: Spontaneous pneumoperitoneum occurring during post partum exercises in the knee-chest position. Am J Obstet Gynecol 1956; 72:903-905
114. 114. Miller RE: The radiological evaluation of intraperitoneal gas (pneumoperitoneum). CRC Crit Rev Clin Radiol Nucl Med 1973; 4:61-85
115. 115. Slonim L, Ross A: Free intra-peritoneal gas - An unusual aetiology. Australas Radiol 1990; 34:168
116. 116. Spaulding LB, Gallop DA: Pneumoperitoneum after hysterectomy. JAMA 1979; 241: 825
117. 117. Tabrinsky J, Mallin LP, Smith JA: Pneumoperitoneum after coitus. Obstet Gynecol 1972; 40:218-220
118. 118. Walker MA: Pneumoperitoneum following a douche. J Kans Med Soc 1942:43-55
119. 119. Varon J, Laufer MD, Sternbach GL: Recurrent pneumoperitoneum following vaginal insufflation. Am J Emerg Med 1991; 9:447-448
120. 120. Fiorelli RL, Kolman SD, Minissale AA, et al: Ovarian carcinoma presenting as pneumoperitoneum: Report of a case and review of the literature. J Am Osteopath Assoc 1988; 88:769-772 [published erratum appears in J Am Osteopath Assoc 1988 88:1064]
121. 121. Longo WE, Ballantyne GH, Graham AJ: Pneumatosis cystoides intestinalis. J Clin Gastroenterol 1987; 9:571-573
122. 122. Lee DH, Lim JH, Ko YT, et al: Sonographic detection of pneumoperitoneum in patients with acute abdomen. AJR Am J Roentgenol 1990; 154:107-109
123. 123. Rowe NM, Kahn FB, Acinapura AJ, et al: Nonsurgical pneumoperitoneum: A case report and a review. Am Surg 1998; 64: 313-322
124. 124. Cameron PA, Rosengarten PL, Johnson WR, et al: Tension pneumoperitoneum after cardiopulmonary resuscitation. Med J Aust 1991; 155:44-47
125. 125. Grosfeld JL, Boger D, Glatsworthy HW: Hemodynamic and manometric observations in experimental air block syndrome. J Pediatr Surg 1971; 6:339-344
126. 126. Hillman KM: Pneumoperitoneum - A review. Crit Care Med 1982; 10:476-481
127. 127. Hinkel CL: Spontaneous pneumoperitoneum without demonstrable visceral perforation. AJR Am J Roentgenol 1940; 43: 377-382
128. 128. Kreel L: Pneumoperitoneum. Postgrad Med 1986; 62:31-32
129. 129. Donahue PK, Steward DR, Osmond JD, et al: Pneumoperitoneum secondary to pulmonary air leak. J Pediatr 1972; 81: 797-800
130. 130. Campanella C, Feilberg VL, Au J: Pneumoperitoneum and pneumoretroperitoneum: A surgical dilemma. Eur J Surg 1991; 157: 425-427
131. 131. Macklin CC: Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum. Arch Int Med 1939; 64: 913-926
132. 132. Macklin MT, Macklin CC: Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: An interpretation of the clinical literature in the light of laboratory experiment. Medicine 1944; 23:281-358
133. 133. Kleinman PK, Raptopoulos V: The anterior diaphragmatic attachments: An anatomic and radiologie study with clinical correlates. Radiology 1985; 155:289-293
134. 134. Shapiro M: Spontaneous pneumothorax complicating pneumoperitoneum therapy: A review and report of a case. Ann Intern Med 1955; 43:876-892
135. 135. Lantsberg L, Rosenzweig V: Pneumomediastinum causing pneumoperitoneum. Chest 1992; 101:1176
136. 136. Murdoch IA, Huggon IC: Rapid diagnosis of the cause of pneumoperitoneum in ventilated asthmatic children. Acta Paediatr 1993; 82:108-110
137. 137. Vanhaesebrouck P, Leroy JG, De Praeter C, et al: Simple test to distinguish between surgical and non-surgical pneumoperitoneum in ventilated neonates. Arch Dis Child 1989; 64:48-49
138. 138. White SE, Reamy K: Sexuality and pregnancy. Arch Sex Behav 1982; 11:429-444
139. 139. Andreone P, L'Heureux P, Strate RG: An unusual cause of massive non-surgical pneumoperitoneum: Case report. J Trauma 1989; 29:1286-1288
140. 140. Uva JL: Spontaneous pneurnothoraces, pneumomediastinum, and pneumoperitoneum: Consequences of smoking crack cocaine. Pediatr Emerg Care 1997; 13: 24-26
141. 141. London NJ, Bailey RG, Hall AW: Spontaneous benign pneumoperitoneum complicating scleroderma in the absence of pneumatosis cystoides intestinalis. Postgrad Med J 1990; 66:61-62
142. 142. Ritchie M, Caravelli J, Shike M: Benign persistent pneumoperitoneum in scleroderma. Dig Dis Sci 1986; 31:552-555
143. 143. Stafford-Brady FJ, Kahn HJ, Ross TM, et al: Advanced scleroderma bowel: Complications and management. J Rheumatol 1988; 15:869-874
144. 144. Wang CL, Wang F, Wong KC, et al: Benign persistent pneumoperitoneum in systemic sclerosis. Singapore Med J 1993; 34: 563-564
145. 145. Harker CP, Neuman TS, Olson LK, et al: The roentgenographic findings associated with air embolism in sport scuba divers. J Emerg Med 1993; 11:443-449
146. 146. Rashleigh-Belcher HJ, Ballham A: Pneumoperitoneum in a sports diver. Injury 1984; 16:47-48
147. 147. Rose DM, Jarczyk PA: Spontaneous pneumoperitoneum after scuba diving. JAMA 1978; 239:223
148. 148. Schriger DL, Rosenberg G, Wilder RJ: Shoulder pain and pneumoperitoneum following a diving accident. Ann Emerg Med 1987; 16:1281-1284
149. 149. Sandler CM, Libshitz HI, Marks G: Pneumoperitoneum, pneumomediastinum and pneumopericardium following dental extraction. Radiology 1975; 115:539-540
150. 150. Fick TE, van Oorschot FH, Mallens WM, et al: Pneumoperitoneum without peritonitis. Neth J Surg 1988; 40:152-154
151. 151. Harshfield DL, Grigg KG: Radiological case of the month. Free intraperitoneal air. J Ark Med Soc 1993; 90:175-176
152. 152. Hussain A, Cox JG: Benign spontaneous pneumoperitoneum in an elderly patient treated medically with recovery. Postgrad Med J 1995; 71:252
153. 153. Stansby G, Novell JR, Thomas JM, et al: Spontaneous pneumoperitoneum. Eur J Surg 1991; 157:71-72