A Case of Cytomegalovirus Enteritis following Ulcerative Colitis with Spontaneous Pneumoperitoneum

Abstract

A 67-year-old man who was being treated for ulcerative colitis was admitted to our hospital because of abdominal distension. Computed tomography showed free air in the abdominal cavity. However, signs of peritonitis or ascites were absent. The physical examination only showed distension and mild tenderness without Blumberg's sign or muscle guarding. Conservative treatment, including antibiotics and abdominocentesis for deaeration, was carried out. Upper and lower gastrointestinal endoscopies demonstrated no perforation site. However, the patient was diagnosed with cytomegalovirus enteritis accompanied by ulcerative colitis and was treated with an anti viral agent. His post-admission course was uneventful. The patient re-started oral intake of solid food on day 4 and was discharged from our hospital on day 17 after treatment. Spontaneous pneumoperitoneum could be treated with conservative therapy when there are no signs of peritonitis and imaging examinations show free air in the abdominal cavity.