本文報告最近三年以來,本院發生的三個不需開刀性腹膜積氣的病例,並討論其成因和鑑別診斷。第一例是位足月產男嬰,因胎便吸入症住院,在使用呼吸器治療後約40小時發生腹膜積氣,僅使用支持療法,10天後情況改善出院。第二個病例是一懷孕36週體重2050公克的早產兒,出生後接受第二次餵食後,發生自發性不需開刀性腹膜積氣,僅以內科療法。第三個病例是一足月產男嬰,出生後不久因橫膈膜疝氣接受緊急手術矯治,術後病兒呈現呼吸窘迫,使用呼吸器治療,發現腹膜積氣持續增加。術後第11天發生大腸菌敗血症,以內科療法,目前在健兒門診追踪。
There were 3 cases of non-surgical pneumoperitoneum during the recent 3 years in Mackay Memorial Hospital. Pneumoperitoneum is often caused by perforation of a viscus that contains gas and usually requires surgical treatment. In case of non-surgical pneumoperitoneum, only medical and supportive treatments are required. The causal mechanism and differential procedures are discussed. Recognition and differentiation of the two types of pneumoperitoneum can prevent unnecessary laparotomy.