Idiopathic spontaneous pneumoperitoneum Deb, Anasua; Ghosh, Binita; Cavazos, Annia ...
Baylor University Medical Center Proceedings,
2/16/2022, Letnik:
35, Številka:
2
Report
Spontaneous pneumoperitoneum is the presence of free air in the peritoneum without evidence of any perforation of hollow viscera. The usual presentation includes acute abdominal pain with ...leukocytosis and elevated inflammatory markers. Here we present a case of spontaneous pneumoperitoneum occurring recurrently in a 58-year-old man with inclusion body myositis and hypertension who presented with cellulitis of both legs. Abdominal computed tomography demonstrated retroperitoneal free air; however, colonoscopy, esophagogastroduodenoscopy, and a prior laparoscopy did not demonstrate any perforation of hollow viscera. Conservative management with antibiotics and symptom control with antiemetics and pain medicines led to clinical improvement, and the patient was discharged home in stable condition.
Fungal empyema is an uncommon condition associated with high morbidity and mortality. Aspergillus empyema thoracis is rare and is usually associated with preexisting chronic empyema, pulmonary ...tuberculosis, or rupture of aspergilloma cavity. This case describes a healthy 20-year-old man presenting with chronic intractable back pain and constitutional symptoms for 6 months who was eventually diagnosed with Aspergillus empyema thoracis, complicated by empyema necessitans extending into multiple ribs and paravertebral areas. He was treated with surgical decortication, chest tube drainage, and systemic antifungal agents. The diagnostic difficulties of fungal empyema thoracis are highlighted.
