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Abstract


Pneumoperitoneum can be defined as free air within the peritoneal cavity. The most common cause of pneumoperitoneum is following intraabdominal surgery.
The other causes of pneumoperitoneum include perforated duodenal or gastric ulcer, ruptured gangreneous appendicitis, trauma producing rupture of the stomach, small bowel or colon and endoscopic examinations such as sigmoidoscopy, cystoscopy and laparotomy, etc. Also, pneomoperitoneum can be occured by barotrauma resulting from excessive airway pressure in the mechanically ventilated patients.
The differential diagnosis is sometimes difficult. but very important to avoid unnecessary exploratory laparotomy with high mortality.
We had experienced barotrauma-induced pneumoperitoneum in the mechanically ventilated patient and had a good result by conservative management reducing peak inspiratory pressure.

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