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Pathophysiology, recognition and management of pneumoretroperitoneum
R Prêtre1, J Robert, D Mirescu
1Department of Surgery, Hôpital Cantonal Universitaire, Geneva, Switzerland.
The British Journal of Surgery
|September 1, 1993
Summary
Pneumoretroperitoneum, or air in the retroperitoneum, is not inherently dangerous. Early diagnosis and source identification are crucial, especially when infection is involved, to ensure timely and appropriate medical intervention.
Area of Science:
- Medicine
- Radiology
- Surgery
Background:
- Pneumoretroperitoneum is the presence of air in the retroperitoneal space.
- The causes and clinical significance of pneumoretroperitoneum require further elucidation.
Purpose of the Study:
- To review cases of pneumoretroperitoneum to understand its causes, extent, and clinical implications.
- To evaluate the diagnostic challenges and outcomes associated with pneumoretroperitoneum.
Main Methods:
- Retrospective review of medical records for 15 patients diagnosed with pneumoretroperitoneum over a 10-year period.
- Analysis of patient data including etiology, anatomical extent of emphysema, diagnostic delays, and patient outcomes.
Main Results:
- Infection, trauma, and iatrogenic causes accounted for the majority of pneumoretroperitoneum cases.
- Emphysema extension to the mediastinum and neck was observed in a subset of patients.
- Diagnostic delays occurred in two patients, and one patient underwent an unnecessary laparotomy due to misdiagnosis.
Conclusions:
- Pneumoretroperitoneum itself is not a dangerous condition.
- Early recognition and prompt identification of the underlying source are critical for effective management, particularly in cases involving sepsis.