Stringfield J T, Graham J P, Watts C M, Bentz R R, Weg J G
JAMA. 1976 Feb 16;235(7):744-6. doi: 10.1001/jama.235.7.744.
Pneumoperitoneum occurred in three adults receiving mechanical ventilatory support. Since the presence of a perforated viscus could not be confirmed by combinations of clinical, surgical, or autopsy findings in any of these patients, it appears that the free abdominal air in these patients was a complication of the ventilatory therapy. It is possible that such a complication may be more common than is currently recognized and thus should be added to the differential diagnosis of pneumoperitoneum.