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Extraperitoneal gas following nephrectomy: patterns and duration.

R A Older, R P Rice, F M Kelvin

    The Journal of Urology
    |July 1, 1978
    PubMed
    Summary
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    Extraperitoneal gas is common after renal operations and can mimic an abdominal abscess. This study documents its incidence and duration, highlighting the importance of recognizing this benign finding in postoperative patients.

    Area of Science:

    • Radiology
    • Surgical Outcomes
    • Abdominal Imaging

    Background:

    • The presence and duration of extraperitoneal gas following major renal operations are not well-documented.
    • Postoperative extraperitoneal gas can be misdiagnosed as an abdominal abscess, leading to potential diagnostic errors in febrile patients.

    Purpose of the Study:

    • To prospectively determine the incidence, duration, and radiographic patterns of extraperitoneal gas in patients after renal operations.
    • To differentiate benign postoperative extraperitoneal gas from pathological collections like abscesses.

    Main Methods:

    • Prospective study involving 41 patients undergoing renal operations.
    • Serial abdominal radiography was performed postoperatively to assess for extraperitoneal gas.
    • Patients with confirmed abscesses were excluded.

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    Main Results:

    • Extraperitoneal gas was observed in 92% of patients between 1-4 days postoperatively.
    • Gas persisted in 71% between 5-8 days and 61% between 9-12 days.
    • Radiographic patterns (linear and bubbly) were often indistinguishable from those of an abscess.

    Conclusions:

    • Extraperitoneal gas is a frequent and often persistent finding after renal surgery.
    • Radiologists and clinicians must be aware of this benign finding to avoid misdiagnosis of abdominal abscesses.