{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T20:09:47Z","timestamp":1779221387267,"version":"3.51.4"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,8,16]],"date-time":"2019-08-16T00:00:00Z","timestamp":1565913600000},"content-version":"vor","delay-in-days":227,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Idiopathic pneumoperitoneum (IP) is a rare phenomenon which merits special attention. It is defined as free intraperitoneal air which is not caused by viscus perforation and does not require surgical intervention. It is generally considered a diagnosis of exclusion and often poses a genuine diagnostic dilemma.<\/jats:p>\n <\/jats:sec>\n \n Presentation of case<\/jats:title>\n We present an unusual case of persistent pneumoperitoneum with no identifiable cause which was found incidentally on a computed tomography (CT) scan in a patient with chronic cough and no prior surgical history. Serial consults revealed no abdominal symptoms or signs. He was managed conservatively and remains asymptomatic despite having a persistent IP on serial radiology.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n To our knowledge, our case is the first in the literature of an idiopathic pneumoperitoneum that persisted on subsequent radiology and was managed successfully without surgical intervention. This is a highly important case for all practicing general surgeons to learn from as knowledge of this phenomenom may help avoid unnecessary surgical intervention and potential morbidities associated with this.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n IP is a diagnosis of exclusion which should only be made after surgical and non-surgical causes have been outruled. In the absence of signs of peritonitis and evidence of gastrointestinal perforation on CT, a conservative approach is warranted, allowing patients to avoid unnecessary surgical intervention.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2019.08.015","type":"journal-article","created":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T11:14:34Z","timestamp":1566040474000},"page":"10-12","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["The clinical dilemma of the persistent idiopathic pneumoperitoneum"],"prefix":"10.1097","volume":"63","author":[{"given":"Enda","family":"Hannan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eltaib","family":"Saad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu","family":"Hoashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desmond","family":"Toomey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-3-20260114","first-page":"41","article-title":"Nonsurgical causes of pneumoperitoneum","volume":"170","author":"Mularski","year":"1999","journal-title":"West. 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Med"},{"key":"R8-3-20260114","first-page":"e2787","article-title":"Massive pneumoperitoneum presenting as an incidental finding","volume":"10","author":"Wang","year":"2018","journal-title":"Cureus"},{"key":"R9-3-20260114","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/j.1742-6723.2010.01357.x","article-title":"Spontaneous pneumoperitoneum: diagnostic and management difficulties","volume":"22","author":"Mann","year":"2010","journal-title":"Emerg. Med. Australas"},{"key":"R11-3-20260114","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s10140-004-0330-y","article-title":"Jacuzzi jet-induced pneumoperitoneum","volume":"10","author":"Williams","year":"2004","journal-title":"Emerg. 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Roentgenol"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221026121930478X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221026121930478X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01612930-201963000-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:18:11Z","timestamp":1768396691000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01612930-201963000-00003"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":13,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2019.08.015","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}