Pneumoperitoneum without clinical peritonitis due to bilateral pyosalpinx.

A case of pneumoperitoneum without clinical peritonitis due to bilateral pyosalpinx is presented. This clinical condition has in the literature been called "spontaneous or idiopathic pneumoperitoneum", and conservative treatment in such cases has been advocated. As shown in our case severe intraperitoneal pathology may exist, and we therefore advocate early explorative laparotomy in all patients with pneumoperitoneum without peritonitis.