Kong V, Cheung C, Elsabagh A, et al. - Researchers aimed at ascertaining the exact yield of pneumoperitoneum on chest radiograph (CXR) following abdominal stab wounds (SW), which is generally considered as surrogate evidence of viscus perforation and an absolute indication for laparotomy. Via conducting this retrospective study on all patients presenting with abdominal SW with no peritoneal signs but having pneumoperitoneum alone and underwent mandatory laparotomy. Among 55 included patients (91% male, mean age: 24 years), 67% (37/55) had positive laparotomy, 28 of which (76%) were considered therapeutic and the remaining 9 (24%) were nontherapeutic. Findings suggest that in patients with no peritoneal signs on initial assessment following abdominal SW, pneumoperitoneum alone cannot be considered an absolute indication for operative exploration. Intra-abdominal injuries were not identified in up to one third of patients. A selective non-operative management approach can be employed to manage this specific subgroup of patients.