Pneumoperitoneum complicating coronary bypass surgery: management without laparotomy.

Drainage of the mediastinum or thoracic cavity following bypass surgery is a routine procedure. A case is reported where pneumoperitoneum developed after the surgical procedure with vague abdominal symptoms accompanied by fever and leukocytosis. Because of the possibility of a rupture of an intra-abdominal organ laparoscopy was performed in this very ill patient and laparotomy avoided. Attention is drawn to this particular group of patients with the sequela of pneumoperitoneum in which laparoscopy can solve the diagnostic dilemma.