<prompt> All of the following are causes of pneumoperitoneum except -Perforated peptic ulcerLaproscopic ProcedurePerforated AppendixHirschsprungs Disease  <response>: Ans. is d i.e., Hirschsprungs Disease o Gas under left hemidiaphragm is due to fundal gas, a normal finding. When gas is present under right hemidiaphragm also its 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 