Delayed retropneumoperitoneum following vaginal laceration i
Introduction
Retropneumoperitoneum is mainly caused by gastrointestinal perforation, usually accompanied by pneumomediastinum or pneumoperitoneum, and requires surgical treatment [1,2,3]. However, cases without perforation have been known to occur, especially in women, because the female genital tract can become a passageway of air into the peritoneal cavity [4]. If the patient does not have a perforated bowel, the decision whether surgical treatment is required can be difficult, particularly in children. Lack of patient cooperation to permit an examination can cause problems in diagnosing abdominal pathology. We describe an unusual case of delayed retropneumoperitoneum caused by a deep vaginal laceration as a result trauma from a water jet in a fountain.

Case report
A 7-year-old premenarcheal girl presented to the emergency department after experiencing an injury from a water jet at a fountain park. While playing in the fountain in a dressed-down style, the patient felt a sharp pain around the anus and subsequently experienced a small amount of bleeding. Initially, the patient's vital sign was within normal range (heart rate 90 to 100 beats/min, blood pressure 110/73 mmHg, and oxygen saturation of 99% to 100%)....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871945/
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