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We present the case of a 44 year old woman with systemic sclerosis who presented with intense abdominal pain without signs of peritonitis.An abdominal computed tomography showed generalized intestinal dilation, intestinal pneumatosis and an extensive pneumoperitoneum.A diagnostic laparoscopy was performed but no perforation nor gastrointestinal leakage were found.Spontaneous pneumoperitoneum in patients with systemic sclerosis without visceral perforation is an extremely rare complication.Physicians must have a low threshold of suspicion for this entity when a patient with systemic sclerosis presents with spontaneous pneumoperitoneum in the absence of peritoneal signs.
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Martínez-Garza et al. (2024) studied this question.
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