Delayed Benign Massive Pneumoperitoneum Associated with Tunneled Peritoneal Drainage Catheter Placement

Gummalla, Krishna Mohan; Pua, Uei

doi:10.1016/j.jvir.2015.02.012

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…We describe an early major complication during the insertion of a percutaneous tunneled peritoneal catheter, which is otherwise a safe method to manage malignant and non-malignant refractory ascites in patients without known adhesions [ 1 – 3 ]. A case series of two patients with pneumoperitoneum, following an ascites drainage implantation, has been reported before [ 4 ]. In both cases pneumoperitoneum developed without bowel perforation and disappeared under conservative management.…”

Section: Discussionmentioning

confidence: 99%

Perforation of the ascending colon during implantation of an indwelling peritoneal catheter: a case report

Paparoupa¹,

Wege²,

Creutzfeldt³

et al. 2020

BMC Gastroenterol

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Background Tunneled peritoneal drainage catheters are described as an effective and relatively safe method in the management of malignant and non-malignant refractory ascites. Therapeutic advantages, linked to their use, are self-management of ascites and palliative care at home. Complications occur rarely. We describe an ascending colon perforation after implantation of a peritoneal drainage in a patient with refractory ascites due to liver cirrhosis. Case presentation The 68-year-old male was admitted to the intensive care unit due to severe community acquired pneumonia. The ascites drainage was inserted in order to reduce the intra-abdominal pressure and enable appropriate ventilation. A few hours later, bowel content could be detected in the tube and an abdominal computed tomography confirmed the intestinal perforation. Notably, there was no pneumoperitoneum and peritonitis had not yet set in. The catheter was removed during an emergency laparotomy and sutured closure of both perforation sites was performed. Conclusion Patients with septated ascites and intraperitoneal adhesions are at potential higher risk of bowel perforation during implantation of an indwelling peritoneal catheter. A mini-laparotomy is, therefore, necessary in order to ensure safe implantation and positioning of the catheter in those cases.

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Section: Discussionmentioning

confidence: 99%

Perforation of the ascending colon during implantation of an indwelling peritoneal catheter: a case report

Paparoupa¹,

Wege²,

Creutzfeldt³

et al. 2020

BMC Gastroenterol

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“…Nonsurgical pneumoperitoneum can occur due to thoracic, abdominal, obstetric and gynecologic, and iatrogenic causes 3 . Various cases of iatrogenic pneumoperitoneum have been reported, and residual pneumoperitoneum after surgery occurs due to iatrogenic causes 4–10 . Nonsurgical pneumoperitoneum should be managed with conservative treatment and careful monitoring when the patient does not have clinical signs or symptoms of peritonitis 3,11 .…”

Section: Introductionmentioning

confidence: 99%

“…3 Various cases of iatrogenic pneumoperitoneum have been reported, and residual pneumoperitoneum after surgery occurs due to iatrogenic causes. [4][5][6][7][8][9][10] Nonsurgical pneumoperitoneum should be managed with conservative treatment and careful monitoring when the patient does not have clinical signs or symptoms of peritonitis. 3,11 Nevertheless, it can be difficult to distinguish between residual pneumoperitoneum and free air caused by anastomotic failure, especially after gastrointestinal surgery, and residual pneumoperitoneum can lead to invasive procedures (eg, exploratory laparotomy) if the patient experiences symptoms.…”

Section: Introductionmentioning

confidence: 99%

The characteristics of residual pneumoperitoneum after laparoscopic colorectal surgery

Fukuhara

Egi

Kochi

et al. 2021

Asian J Endoscop Surgery

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Introduction: Despite the popularity of laparoscopic surgery, it remains unclear whether residual pneumoperitoneum influences the patient's postoperative course. This study aimed to evaluate the characteristics of residual pneumoperitoneum.Methods: This retrospective study included 201 Japanese patients who had undergone elective laparoscopic colorectal surgery. The patients were divided into groups, with and without anastomotic failure; the non-anastomotic failure group was further divided into subgroups, with and without residual pneumoperitoneum. Patient characteristics were compared between the various groups. Results: The group with residual pneumoperitoneum included 57 patients (30.3%). Percutaneous drainage was required for one patient with residual pneumoperitoneum. Univariate analyses revealed that residual pneumoperitoneum was associated with low values for body mass index (BMI) and subcutaneous fat area (SFA). Furthermore, relative to the group with anastomotic failure, the group without anastomotic failure but with residual pneumoperitoneum had lower values for inflammatory markers. Conclusion:Low BMI and SFA values were identified as risk factors for residual pneumoperitoneum. Inflammatory markers may be useful as indicators for avoiding emergent surgery when it is difficult to differentiate between asymptomatic residual pneumoperitoneum and free air related to anastomotic failure.

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Delayed Benign Massive Pneumoperitoneum Associated with Tunneled Peritoneal Drainage Catheter Placement

Cited by 2 publications

References 4 publications

Perforation of the ascending colon during implantation of an indwelling peritoneal catheter: a case report

Perforation of the ascending colon during implantation of an indwelling peritoneal catheter: a case report

The characteristics of residual pneumoperitoneum after laparoscopic colorectal surgery

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