{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T13:20:00Z","timestamp":1775827200573,"version":"3.50.1"},"reference-count":8,"publisher":"SMC Media","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction:\u00a0Pneumoperitoneum is commonly associated with a perforated hollow viscus and often prompts emergency surgical intervention. However, not all cases necessitate operative management. A rare but important cause of pneumoperitoneum is air insufflation through the perianal route, which can lead to extensive subcutaneous emphysema and intra-abdominal free air without evidence of visceral perforation. Case description:\u00a0We present a case of pneumoperitoneum following perianal air insufflation managed conservatively after a thorough clinical and radiological assessment revealed no indication for surgery. Conclusion:\u00a0This case underscores the importance of distinguishing non-surgical from surgical pneumoperitoneum. Early recognition and appropriate conservative treatment can prevent unnecessary operative interventions and their associated risks.<\/jats:p>","DOI":"10.12890\/2026_006464","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:54:50Z","timestamp":1775570090000},"source":"Crossref","is-referenced-by-count":0,"title":["Pneumoperitoneum following perineal air insufflation can be managed conservatively"],"prefix":"10.12890","volume":"13","author":[{"given":"Mohammad","family":"Alabdallat","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ammar","family":"Almadani","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murad","family":"Alahmad","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Kloub","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayman","family":"El-Menyar","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Clinical Research, Hamad Medical Corporation, Doha, Qatar; Clinical Medicine, Weill Cornell Medicine, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Rizoli","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Al-Thani","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"10.12890\/2026_006464_ref1","doi-asserted-by":"crossref","unstructured":"Corsi AJ, Soukat Ali A, Kumar D. Self-inflicted abdominal air insufflation leading to diffuse subcutaneous emphysema, pneumoperitoneum, pneumomediastinum, pneumopericardium, and pneumothorax: a case report. Cureus 2022;14:e30278. doi: 10.7759\/cureus.30278","DOI":"10.7759\/cureus.30278"},{"key":"10.12890\/2026_006464_ref2","doi-asserted-by":"crossref","unstructured":"Bakka HSA, Babu PK, Kutikuppala LVS, Suvvari TK, Koirala SB. A case of tension pneumoperitoneum with fecal peritonitis due to high-pressure air insufflation through the anus. Clin Case Rep 2023;11:e7344. doi: 10.1002\/ccr3.7344","DOI":"10.1002\/ccr3.7344"},{"key":"10.12890\/2026_006464_ref3","doi-asserted-by":"crossref","unstructured":"Sidiqi MM, Fletcher D, Billah T. The enigma of asymptomatic idiopathic pneumoperitoneum: a dangerous trap for general surgeons. Int J Surg Case Rep 2020;76:33\u201336. doi: 10.1016\/j.ijscr.2020.09.149","DOI":"10.1016\/j.ijscr.2020.09.149"},{"key":"10.12890\/2026_006464_ref4","doi-asserted-by":"crossref","unstructured":"Alassaf M. Recurring spontaneous aseptic pneumoperitoneum presenting secondary to an unrelated chief complaint: a case report. Int J Surg Case Rep 2015;7C:96\u201398. doi: 10.1016\/j.ijscr.2014.10.038","DOI":"10.1016\/j.ijscr.2014.10.038"},{"key":"10.12890\/2026_006464_ref5","doi-asserted-by":"crossref","unstructured":"Estridge P, Akoh JA. Recurrent spontaneous pneumoperitoneum: a surgical dilemma. Int J Surg Case Rep 2017;30:103\u2013105. doi: 10.1016\/j.ijscr.2016.11.053","DOI":"10.1016\/j.ijscr.2016.11.053"},{"key":"10.12890\/2026_006464_ref6","doi-asserted-by":"crossref","unstructured":"Shamim AA, Zeineddin S, Zeineddin A, Olufajo OA, Mathelier GO, Cornwell Iii EE, et al. Are we doing too many non-therapeutic laparotomies in trauma? An analysis of the National Trauma Data Bank. 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