RT Book, Section A1 Gomella, Tricia Lacy A1 Eyal, Fabien G. A1 Bany-Mohammed, Fayez SR Print(0) ID 1168356974 T1 Pneumoperitoneum T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781259644818 LK accesspediatrics.mhmedical.com/content.aspx?aid=1168356974 RD 2022/08/10 AB A pneumoperitoneum is seen on an abdominal radiograph. A pneumoperitoneum is an abnormal collection of free air in the peritoneal cavity. The air can be secondary to perforation of the gastrointestinal (GI) tract (most common, approximately 90% of cases) or from the respiratory tract, or it can be idiopathic with no known cause. Necrotizing enterocolitis (NEC) with perforation is the most common cause of a pneumoperitoneum in the neonate, and it carries a high mortality rate. Approximately 78.5% of pneumoperitoneums were secondary to NEC; therefore, a neonate with a pneumoperitoneum requires immediate evaluation and treatment because early recognition is important in successful management. It is important to note that a diagnosis of a pneumoperitoneum does not always imply a GI perforation. Careful assessment of each case can limit unnecessary laparotomies and their surgical complications.