A comparative analysis of conservative management and laparotomy in cases of free air after blunt abdominal trauma: A comprehensive case series investigation

Blunt abdominal trauma resulting in injuries to hollow organs is uncommon, accounting for 1%–3% of cases. Diagnosing the condition remains challenging because of the absence of a standardized approach and the limitations of commonly used imaging techniques. We presented two cases of pneumoperitoneum resulting from blunt abdominal trauma. One was managed conservatively, and the other was managed with laparotomy. This article delves into the controversies surrounding the accuracy of computed tomography scans for hollow viscus injuries and advocates for a more nuanced diagnostic approach. The presence of free air alone should not prompt laparotomy, as demonstrated by our cases and supported by existing literature. We propose a cautious and conservative strategy in specific cases to minimize unnecessary laparotomies and their associated complications.