Pneumoperitoneum: A review of nonsurgical causes

Abstract

Most cases of NSP occurred as a procedural complication or as a complication of medical intervention. The most common abdominal etiology of NSP was retained postoperative air (prevalence 25% to 60%). NSP occurred frequently after peritoneal dialysis catheter placement (prevalence 10% to 34%) and after gastrointestinal endoscopic procedures (prevalence 0.3% to 25%, varying by procedure). The most common thoracic causes included mechanical ventilation, cardiopulmonary resuscitation, and pneumothorax. One hundred ninety-six case reports of NSP were recorded, of which 45 involved surgical exploration without evidence of perforated viscus. The clinician should maintain a high index of suspicion for nonsurgical causes of pneumoperitoneum and should recognize that conservative management may be indicated in many cases.

Postoperative pneumoperitoneum after colorectal surgery: Expectantvssurgical management

“…These are categorized as follow: pseudopneumoperitoneum, thoracic, abdominal, gynecological and idiopathic [3,8,[18][19][20][21][22] . Table 1 lists the pathophysiological mechanisms for causes of nonsurgical pneumoperitoneum [2,4,19,20,22,23] . Pseudopneumoperitoneum is described as the simulated roentgenographic appearance of free intraperitoneal air [18,20] .…”

“…Table 1 lists the pathophysiological mechanisms for causes of nonsurgical pneumoperitoneum [2,4,19,20,22,23] . Pseudopneumoperitoneum is described as the simulated roentgenographic appearance of free intraperitoneal air [18,20] . Features that can be used to discriminate this from true free peritoneal air include failure of air to shift location with different radiographic positioning and failure of radiolucency to collect in the most superior possible position [14] .…”

Benign pneumoperitoneum – complications after colonoscopy

“…Postępowanie w przypadku stwierdzenia odmy otrzewnowej wciąż budzi kontrowersje i jest powodem dyskusji, ponieważ ustalenie jej przyczyn często bywa trudne [5]. Jak wynika z danych medycznych, 5-15% przypadków odmy otrzewnowej nie wymaga leczenia operacyjnego [8]. W przypadku odmy łagodnej, kiedy nie występują wzdęcia i bóle brzucha, nie stwierdza się objawów otrzewnowych i leukocytozy, leczenie powinno się ograniczać głównie do dożylnej antybiotykoterapii [6].…”

Percutaneous Endoscopic Gastrostomy in Neurological Patients

“…The most common thoracic causes included mechanical ventilation, cardiopulmonary resuscitation, and pneumothorax. Clinicians should maintain a high index of suspicion for nonsurgical causes of pneumoperitoneum and should recognize that conservative management may be indicated in many cases (Mularski et al, 2000). In one study of patients undergoing PEG placement, of the 65 patients who underwent PEG placement, 13 developed a pneumoperitoneum on the initial chest radiograph; 10 of the 13 patients experienced complete resolution of pneumoperitoneum at 72 hours, and in 3 patients, the free air persisted but was of no clinical significance (Wiesen et al, 2006).…”