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Usually, pneumoperitoneum is due to perforation of a hollow abdominal organ. In the absence of peritoneal symptoms, pneumoperitoneum may be due to other causes. Two patients with an unnecessary laparotomy for pneumoperitoneum without peritonitis are presented. More knowledge of the less frequent causes of pneumoperitoneum without peritonitis can possibly contribute to refraining from exploratory laparotomy in these cases.
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