Ventilator-induced pneumoperitoneum--a rapid diagnosis.

Pneumoperitoneum found on abdominal roentgenography in the newborn usually indicates intestinal perforation. With the increased use of high pressure ventilation, pneumoperitoneum secondary to air dissecting transdiaphragmatically is being encountered with greater frequency.1-3 Accurate differentiation between respirator-associated pneumoperitoneum and perforated viscus can save the neonate a needless surgical exploration at a time when an operation is least able to be tolerated. This report reviews our recent experience with six neonates and suggests a rapid method to differentiate a surgical from a nonsurgical cause of pneumoperitoneum. CLINICAL DATA Six neonates with positive pressure ventilationinduced pneumoperitoneum were encountered at The Children9s Hospital, Denver, between 1976 and 1979.