Document Detail

Severe pneumoperitoneum caused by infected pelvic hematoma: report of a case and review of the literature.
MedLine Citation:
PMID:  20163261     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pneumoperitoneum usually is caused by hollow viscus perforation with associated peritonitis. Severe pneumoperitoneum secondary to infection of a hematoma with gas-forming organisms is exceedingly rare. METHODS: Case report and literature review. RESULTS: A 43-year-old man with a history of abdominoperineal resection for rectal cancer developed abdominal distention, fever, and elevated white blood cell count after lysis of adhesions with bowel resection for recurrent small bowel obstruction. Abdominal radiography and a computed tomography scan demonstrated a large amount of free air in the peritoneal cavity. Contrary to expectations, reexploration revealed no signs of viscus perforation or anastomotic leak, but instead a large pelvic hematoma with an odor was identified and evacuated. Cultures from the hematoma yielded anaerobic gram-negative bacilli (not Bacteroides fragilis). The patient recovered uneventfully. CONCLUSION: Infected hematoma should be recognized as a cause of pneumoperitoneum after surgery. Awareness of this rare condition may prevent unnecessary surgical explorations in doubtful situations.
Hongyi Cui
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Surgical infections     Volume:  11     ISSN:  1557-8674     ISO Abbreviation:  Surg Infect (Larchmt)     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-18     Completed Date:  2010-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815642     Medline TA:  Surg Infect (Larchmt)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-6     Citation Subset:  IM    
Department of General and Laparoscopic Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, 55 Lake Avenue, Worcester, MA 01655, USA.
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MeSH Terms
Bacteroides Infections / complications*,  diagnosis*,  microbiology
Hematoma / complications*
Pelvic Infection / complications*,  diagnosis*,  microbiology
Pneumoperitoneum / diagnosis*,  microbiology
Radiography, Abdominal
Rectal Neoplasms / complications

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