Pneumoperitoneum following percutaneous endoscopic gastrostomy. A prospective study

Percutaneous endoscopic gastrostomy (PEG) is a safe and widely used technique to establish an enteral feeding route. It has eliminated much of the operative morbidity associated with gastrostomy placed by laparotomy. The authors recently observed a patient who developed a benign pneumoperitoneum following PEG. Twenty-four patients were then prospectively studied after PEG to determine the incidence and significance of this finding. Nine patients (38%) developed radiologic pneumoperitoneum. Five patients (21%) had gross evidence of pneumoperitoneum, three patients had more subtle findings of small amounts of free air, and one patient had free air found by CT scan. No patient developed signs or symptoms of peritoneal inflammation. The authors conclude that pneumoperitoneum following PEG occurs frequently and that, in the absence of signs or symptoms of peritoneal inflammation, it is a benign finding which requires no further diagnostic or therapeutic intervention.