THERAPEUTIC MANAGEMENT OF PNEUMOPERITONEUM

Abstract

Pneumoperitoneum consists of the presence of free air or gas in the peritoneal cavity and is characterized as a clinical and radiological finding whose therapeutic management varies greatly depending on its etiology. Although frequently associated with perforation of hollow viscera, pneumoperitoneum can also occur in non-perforative, iatrogenic, or therapeutic contexts. This study is based on a literature review to examine different therapeutic strategies according to the clinical context. This is a narrative literature review based on articles published in the last five years and conducted in the PubMed database. Regarding secondary or idiopathic pneumoperitoneum, the literature indicates that, without clear signs of gastrointestinal perforation (in pediatric patients) or in the absence of peritonitis or sepsis (in adults), conservative management may be more appropriate. This condition, associated with lenvantinib-induced pneumatosis intestinalis, requires immediate interruption of therapy. On the other hand, it presents relevant therapeutic applications, such as in laparoscopic surgery and in preoperative progressive pneumoperitoneum for complex hernias, where its use allows for more effective interventions and improves clinical outcomes. Therefore, it is concluded that the therapeutic management of pneumoperitoneum should be carefully adopted according to a broad, individualized clinical, laboratory, and radiological context, in order to avoid complications arising from its treatment or therapeutic application.