{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:30:26Z","timestamp":1753878626677,"version":"3.41.2"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100010724","name":"Health Systems Research Institute","doi-asserted-by":"publisher","award":["67\u2010130"],"award-info":[{"award-number":["67\u2010130"]}],"id":[{"id":"10.13039\/501100010724","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020648","name":"Royal College of Physicians of Thailand","doi-asserted-by":"publisher","award":["02\/66"],"award-info":[{"award-number":["02\/66"]}],"id":[{"id":"10.13039\/100020648","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pneumoperitoneum, or free air in the peritoneal cavity, typically indicates visceral organ perforation requiring urgent surgical intervention. In peritoneal dialysis (PD) patients, however, it can occur without prior surgery or trauma, often due to technical errors, and may mimic peritonitis, risking misdiagnosis and unnecessary treatment. We report a case of a 73\u2010year\u2010old male PD patient presenting with fever, abdominal pain, and bowel ileus, initially raising concerns for organ perforation due to pneumoperitoneum. A comprehensive diagnostic workup and history taking, including molecular testing, excluded infections and chemical causes such as icodextrin, drugs, bile, faeces, blood, and malignancy. The cause was traced to improper PD technique, specifically a lapse in the \u2018flush\u2010before\u2010fill\u2019 method. Conservative management and retraining led to full symptom resolution and disappearance of the free air. This case highlights the importance of thorough diagnostic evaluations to rule out serious causes of pneumoperitoneum in PD patients, emphasizing the role of proper PD technique and patient education in preventing complications. Pneumoperitoneum in PD patients can mimic peritonitis, posing a diagnostic challenge. Comprehensive evaluation and adherence to proper PD practices are essential to avoid unnecessary interventions.<\/jats:p>","DOI":"10.1111\/nep.14416","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T06:19:07Z","timestamp":1736230747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Deceptive air: Unravelling pseudo\u2010peritonitis in peritoneal dialysis patients\u2014A diagnostic challenge"],"prefix":"10.1111","volume":"30","author":[{"given":"Aschariya","family":"Wipattanakitcharoen","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piyaporn","family":"Towannang","sequence":"additional","affiliation":[{"name":"Peritoneal Dialysis Excellent Center King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuttha","family":"Lumlertgul","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natavudh","family":"Townamchai","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University  Bangkok Thailand"},{"name":"Renal Immunology and Renal Transplant Research Unit, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2996-8934","authenticated-orcid":false,"given":"Talerngsak","family":"Kanjanabuch","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University  Bangkok 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