Pneumoperitoneum and Pneumoretroperitoneum in Blunt Trauma Patients

Nishina, Masayoshi; Fujii, Chiiho; Ogino, Ryukoh; Kobayashi, Ryozo; Kohama, Akitsugu

doi:10.1097/00005373-200009000-00029

Cited by 20 publications

(13 citation statements)

References 10 publications

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“…In the present study more than half of the patients who had FIA (53%) had free intra-peritoneal fluid. This makes the clinical diagnosis of bowel perforation even more difficult especially in patients with low level of consciousness [12]. All FIA positive patients had severe multiple injuries having a mean ISS of 18.8 which is similar to other studies [12].…”

Section: Discussionsupporting

confidence: 78%

“…Triple contrast CT scan (oral, rectal and intravenous contrast) 6-8 h after the initial evaluation, may increase the specificity of CT scan and correctly detect the bowel perforation [1,3]. The need for surgical intervention in patients with FIA is highly dependent on the clinical judgement which may be more difficult in multi-trauma patients [12]. Diagnostic peritoneal lavage may be useful in this situation [20].…”

Section: Regionmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of free intraperitoneal air detected by CT scan in diagnosing bowel perforation in blunt trauma: Experience from a community-based hospital

Hefny¹,

Kunhivalappil²,

Matev³

et al. 2015

Injury

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Section: Discussionsupporting

confidence: 78%

Section: Regionmentioning

confidence: 99%

Usefulness of free intraperitoneal air detected by CT scan in diagnosing bowel perforation in blunt trauma: Experience from a community-based hospital

Hefny¹,

Kunhivalappil²,

Matev³

et al. 2015

Injury

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“…Diagnostic laparocope may be an alternative in high index of suspicion. Masayoshi etal suggested the criteria for non surgical approach in a setting of pneumoperitoneum are (a)thorough physical examination (b)no peritoneal signs (c)pneumothorax (d)negative DPL (e) no intraperitoneal effusions in USG /CT (f )closed observation and repeated examination (g)absence of major brain injury, or altered sensorium [9]. In our case, the presence of imprint abrasions over the left half of abdomen, diffuse tenderness and minimal fluid in the abdominal cavity made us to do diagnostic laparoscopy.…”

Section: Case Discussionmentioning

confidence: 99%

Spontaneous Pnemoperitoneum after Blunt Trauma Chest –Diagnostic Dilemma-Role of Diagnostic Laparoscopy – Case Report

Nayak¹,

Mishra²,

Soren³

et al. 2013

J Trauma Treat

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Introduction: Pneumoperitoneum is a striking feature of hollow viscous perforation and may need of immediate surgical intervention. Blunt trauma chest with pneumoperitoneum without evidence of hollow viscous perforation is unusual and the condition is called spotaneous pneumoperitoneum. Case Presentation: A 29 year male presented to the emergency department after a road traffic accident with hypotension and respiratory distress. Clinically there was surgical emphysema associated with diminished breath sound over left half of the chest and multiple contusions over left hypochondrium and left flank. Bedside X-ray showed fracture of ribs on left side with pneumothorax and air under both the dome of diaphragm. Emergency tube thoracostomy done and respiratory symptoms improved. Further patient evaluated with Ultrasound abdomen and Computerized tomogram of abdomen. Dilated bowels, gross pneumoperitoneum with minimal fluid collection was noted. Diagnostic laparoscopy done to find out hollow viscous perforation or diaphragm injury but to the surprising hollow viscous and diaphragm found to be normal. Case Discussion: Pneumothorax and pnemoperitoneum with presence of abdominal contusions make the surgeon in dilemma for choosing conservative or therapeutic approach. Conclusion: Diagnostic laparoscopy with systemic exploration of abdominal organs and spaces will help in diagnosis and mandatory laparotomy may avoided.

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“…In hemodynamically stable human blunt or penetrating trauma patients, the most sensitive and specific diagnostic procedures to detect intraabdominal injury remain controversial and challenging to interpret . In blunt trauma patients, CT findings of pneumoperitoneum are not pathognomonic for a ruptured viscus; this was especially true in patients with a pneumothorax . Although CT is widely accepted as the gold standard for the diagnosis of intraabdominal injury, sonography (FAST) is often recommended as the first step in the imaging assessment of patients with blunt abdominal trauma; it is even considered the gold standard in some reports .…”

Section: Discussionmentioning

confidence: 99%

Nonsurgical pneumoperitoneum in a dog secondary to blunt force trauma to the chest

Simmonds

Whelan²,

Basseches³

2011

J Vet Emergen Crit Care

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Cases of nonsurgical pneumoperitoneum have rarely been reported in the veterinary literature. A thoracic source of pneumoperitoneum should be considered when the suspicion of a ruptured viscus is low based on diagnostic procedures (eg, ultrasound, computed tomography, and diagnostic peritoneal lavage), in addition to physical examination (eg, lack of fever and absence of abdominal pain) and laboratory findings (eg, absence of inflammatory leukogram).

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Pneumoperitoneum and Pneumoretroperitoneum in Blunt Trauma Patients

Cited by 20 publications

References 10 publications

Usefulness of free intraperitoneal air detected by CT scan in diagnosing bowel perforation in blunt trauma: Experience from a community-based hospital

Usefulness of free intraperitoneal air detected by CT scan in diagnosing bowel perforation in blunt trauma: Experience from a community-based hospital

Spontaneous Pnemoperitoneum after Blunt Trauma Chest –Diagnostic Dilemma-Role of Diagnostic Laparoscopy – Case Report

Nonsurgical pneumoperitoneum in a dog secondary to blunt force trauma to the chest

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