We discuss the case of a 17-year-old patient who had an acute abdomen and elevated inflammatory markers and underwent laparoscopy for suspected bowel perforation after a CT scan revealed pneumoperitoneum. A ruptured viscus is indicated by pneumoperitoneum on an X-ray or computed tomography (CT) scan, and surgery is required right away. It's unusual to see a tubo-ovarian abscess (TOA) with pneumoperitoneum. An abscess affecting the adnexa has produced pneumoperitoneum in a very small number of patients. The findings were compatible with TOA and ruled out bowel perforation. Her abscess was drained, she was given intravenous antibiotics, and she recovered well afterward. The pneumoperitoneum could have been caused by E. coli coinfection, as the patient had an E. coli-related urinary tract infection three weeks prior to presentation, or gradual TOA leaking. Finally, gas behind the diaphragm can be caused by non-bowel-related gynaecological pathology, but it's important to rule out other possibilities.
Author(S) Details
Remya Aryad
Department of Obstetrics and Gynecology, Blacktown Hospital, NSW, Australia.
Sujana Molakatalla
Department of Obstetrics and Gynecology, Blacktown Hospital, NSW, Australia.
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