This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Peritoneal Disorders - Peritonitis, Subject name: Surgery
[{'content': "All of the following are causes of pneumoperitoneum except - \nSelect and explain. \nA. Perforated peptic ulcer, B. Laproscopic Procedure, C. Perforated Appendix, D. Hirschsprung's Disease", 'role': 'user'}, {'content': "Answer: D \nExplanation: Ans. is 'd' i.e., Hirschsprung's Disease o Gas under left hemidiaphragm is due to fundal gas, a normal finding. When gas is present under right hemidiaphragm also it's due to pneumoperitoneum.Causes of Pneumoperitoneum1. Perforation of GI tract# Peptic ulcer# Inflamamtion (diverticulitis, appendicitis, toxic megacolon, necrotizing enterocolitis)# Infarction# Malignant neoplasm# Obstruction# Pneumatosis cystoides rupture# Iatrogenic-endoscopy2. Iatrogenic# Surgery, peritoneal dialysis, drainage catheters, biopsies3. Penetrating abdominal injury.4. Through female genital tracta. Spontaneousb. Iatrogenic# Iatrogenic perforation of uterus or vagina# Culdocentesis# Tubal patency test5. Gas forming peritonitis6. Pneumothorax with pleuroperitoneal fistula", 'role': 'assistant'}]