Benign Post-traumatic Pseudopneumoperitoneum: A Diagnostic Pitfall in Blunt Trauma

Abstract

Benign post-traumatic pseudopneumoperitoneum is an uncommon imaging finding that may mimic true pneumoperitoneum in trauma patients. It is typically characterized on computed tomography by an isolated pocket of air between the fifth and tenth intercostal spaces, usually near the costochondral junction. The pathogenesis of benign post-traumatic pseudopneumoperitoneum is uncertain but may relate to a vacuum phenomenon induced by tissue pressure changes. Recognition of this benign entity is essential to differentiate it from true pneumoperitoneum, which often requires surgical exploration, thereby avoiding misdiagnosis and inappropriate intervention.

We report a case of a patient in the context of blunt thoracoabdominal trauma, in which computed tomography demonstrated intercostal ectopic air anterior to the liver, which was diagnosed as benign post-traumatic pseudopneumoperitoneum. The patient remained stable and was managed conservatively, avoiding unnecessary laparotomy.