A Case Report of Spontaneous Pneumoperitoneum Related to Scleroderma without Evidence of Pneumatosis Cystoides Intestinalis

We report a case of a 72-year-old male with a history of scleroderma who presented to the emergency room with an asymptomatic pneumoperitonum after undergoing a CT thorax for evaluation of intersitial lung disease. Abdominal imaging was performed with oral contrast and did not reveal extravasation of the contrast into the peritoneum suggesting there was no perforated viscus. The patient was managed conservatively with serial abdominal exams, bowel rest, empiric antibiotics, supplemental oxygen, and total parenteral nutrition. The patient was subsequently diagnosed with a spontaneous pneumoperitoneum related to scleroderma without evidence of pneumatosis cystoides intestinalis. Over a course of 3 months the pneumoperitoneum resolved and the patient remained well.