Persistent Asymptomatic Pneumoperitoneum With Spontaneously Resolving Idiopathic Pneumatosis Intestinalis: A Case Report.

We present our experience with a patient with acute-on-chronic asymptomatic pneumoperitoneum with spontaneously resolving idiopathic pneumatosis intestinalis that was solely managed on close observation alone. This case is unique in that it details the approach to nonoperative management of massive free air under the diaphragm identified incidentally on routine preventative health screening and longitudinal follow-up over an 8-month period. In the absence of known and underlying systemic disease, efficient and coordinated clinical work-up and evaluation for comorbid diagnoses associated with pneumoperitoneum can serve to guide management and avoid unnecessary surgery for stable and asymptomatic patients.