Is the conservative treatment the choice for the spontaneous pneumoperitoneum

Introduction: the most common cause of a pneumoperitoneum is a perforation in the gastrointestinal tract. However, in 5–14% of the cases it presents without perforation, and is called spontaneous pneumoperitoneum or nonsurgical pneumoperitoneum. the spontaneous pneumoperitoneum may occur without systemic disruption, pain, or laboratory abnormality. In these cases, the conservative treatment is an option. case series: We present three patients diagnosed with spontaneous pneumoperitoneum treated conservatively in Hospital del Mar (barcelona). All three patients presented a proper evolution with the conservative treatment, without any complications, and without requiring a surgery. conclusion: the conservative treatment for the spontaneous pneumoperitoneum is a feasible, secure and the first choice when no hemodynamic instability, pain, leukocytosis, fever or peritonism is present.