A Rare Cause of Retropneumoperitoneum

Pau Pla Sanchez; Joaquin Munoz Rodriguez

A Rare Cause of Retropneumoperitoneum

Pau Pla Sanchez^* and Joaquin Munoz Rodriguez

Complutense University of Madrid, Madrid, Spain

*Corresponding Author:: Sanchez PP
Complutense University of Madrid, Madrid, Spain
Tel: 0034 620541910
E-mail: paups88@gmail.com

Received Date: April 24, 2017; Accepted Date: April 25, 2017; Published Date: April 26, 2017

Citation: Sanchez PP, Rodriguez JM (2017) A Rare Cause of Retropneumoperitoneum. J Surgery Emerg Med 1:1.

Copyright: © 2017 Sanchez PP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

A 40-year-old man underwent anal exploration due to an ischiorrectal abscess. Drainage of the abscess and instillation of hydrogen peroxide (HPO) to evidence any perianal fistula was performed. In the forth postoperative day the patient presents fever accompanied by a painful palpable mass in the right iliac fossa (RIF). Laboratory studies revealed elevated white blood count with neutrophilia.

Keywords

Retropneumoperitoneum; Ischiorrectal abscess; Perianal fistula; Hydrogen peroxide

Clinical Image

An urgent CT scan was performed suspecting an ascending progression of the perianal infection. The scan showed a collection with extraperitoneal gas, dissecting the perirectal pelvic fat and ascending to preperitoneal fat. Fearing the possibility of infection by gas-producing bacteria, empirical antibiotic therapy was initiated and an emergency surgery was performed. An incision at the RIF was made followed by a thorough inspection of the affected area, without finding any signs of infection. These and further negative cultures of the samples, indicate that HPO was the primary cause of the retropneumoperitoneum (Figures 1 and 2).