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Related Experiment Videos

Postoperative pneumoperitoneum: an unusual etiology

M Tenembaum, J J Bauer, I M Gelernt

    Annals of Surgery
    |December 1, 1978
    PubMed
    Summary

    Postoperative pneumoperitoneum can be concerning, especially with worsening symptoms. This study suggests drain removal, particularly in patients on corticosteroids, may cause pneumoperitoneum, necessitating careful evaluation for visceral perforation.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Radiology

    Background:

    • Postoperative pneumoperitoneum is common after abdominal surgery.
    • Worsening pneumoperitoneum with abdominal findings requires careful assessment.

    Observation:

    • Four patients with inflammatory bowel disease on corticosteroids developed pneumoperitoneum after drain removal.
    • Clinical signs included abdominal tenderness, peritoneal signs, and paralytic ileus.

    Findings:

    • Pneumoperitoneum was confirmed radiographically.
    • Contrast studies ruled out hollow viscus perforation in most cases.
    • Conservative management with observation led to full recovery.

    Implications:

    • Drain removal, especially in corticosteroid-treated patients, can cause or worsen pneumoperitoneum.

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  • It is crucial to rule out hollow viscus perforation before attributing pneumoperitoneum solely to drain removal.