Significance of radiologic evidence of free air following laparoscopy

Electrocautery accidents, especially bowel burns, are one of the major causes of morbidity associated with laparoscopic tubal coagulation. Early recognition of such injury is highly desirable. Radiologic evidence of free air, ordinarily suggesting bowel perforation, may not be of diagnostic significance in such patients. Postlaparoscopic radiologic study of 26 patients revealed significant, projected areas of free air among 38.5% of patients 24 hours later. It is suggested that physicians rely on clinical judgement in cases of thermal bowel injury in the immediate postoperative period.