Williams N M, Watkin D F
Department of Surgery, Leicester Royal Infirmary, UK.
Postgrad Med J. 1997 Sep;73(863):531-7. doi: 10.1136/pgmj.73.863.531.
Intraperitoneal free gas seen radiologically as air under the diaphragm nearly always indicates a perforated abdominal viscus that requires surgical intervention. Rarely, however, the presence of a pneumoperitoneum may not indicate an intra-abdominal perforation and thus may not require laparotomy. Such a situation is termed spontaneous or nonsurgical pneumoperitoneum. In this review, we explore the aetiological mechanisms and the pathophysiology of the appearance of intra-abdominal free gas. An appreciation of the condition and its likely aetiological factors should improve awareness and possibly reduce the imperative to perform an emergency laparotomy on an otherwise well patient with an unexplained pneumoperitoneum.
放射学检查显示腹腔内游离气体表现为膈下积气，几乎总是提示存在需要手术干预的腹腔脏器穿孔。然而，气腹的存在很少情况下可能并不提示腹腔内穿孔，因此可能不需要剖腹手术。这种情况被称为自发性或非手术性气腹。在本综述中，我们探讨腹腔内游离气体出现的病因机制和病理生理学。了解这种情况及其可能的病因因素应能提高认识，并可能减少对患有不明原因气腹但其他方面状况良好的患者进行急诊剖腹手术的必要性。
