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Post‐partum pneumoperitoneum: Not a surgical emergency

Free air under the diaphragm and clinical findings of peritonitis indicate a perforated hollow viscus in over 90% of patients. However, in the remaining 10% of cases, pneumoperitoneum is not the result of a visceral perforation and does not always warrant emergency surgery. Fever, leucocytosis and abdominal pain are often minimal or absent in these patients. An example of the latter group is postpartum pneumoperitoneum, which is a rare but well-described phenomenon. The ability of air to enter the peritoneal cavity through the uterus and fallopian tubes was discovered in 1875. Following the first report of post-partum pneumoperitoneum in 1953, a total of ten cases have so far been reported in the literature, the majority of which occurred in the late 1950s and early 1960s. This is an important differential diagnosis to consider in post-partum patients because most resolve without surgical intervention.